| Prism Health Belmont | |
|
2236 Se Belmont St Portland OR 97214-2817 | |
| (503) 278-3890 | |
| Not Available |
| Full Name | Prism Health Belmont |
|---|---|
| Speciality | Clinic/Center |
| Location | 2236 Se Belmont St, Portland, Oregon |
| Authorized Official Name and Position | Jessica Loraine Cole (SNR DIR COMPLIANCE & RISK MANAGEMEN) |
| Authorized Official Contact | 5032783813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prism Health Belmont 520 Nw Davis St Ste 215 Portland OR 97209-3620 Ph: (503) 278-3890 | Prism Health Belmont 2236 Se Belmont St Portland OR 97214-2817 Ph: (503) 278-3890 |
| NPI Number | 1275076168 |
|---|---|
| Provider Enumeration Date | 11/23/2016 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/29/2024 |
| Medicare PECOS PAC ID | 8729363502 |
|---|---|
| Medicare Enrollment ID | O20170316002402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275076168 | NPI | - | NPPES |
| Provider Name | Holly J Balsbaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710082532 PECOS PAC ID: 3476653239 Enrollment ID: I20070709000299 |
| Provider Name | Amy Londergan Wiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174573927 PECOS PAC ID: 5799706966 Enrollment ID: I20080508000040 |
| Provider Name | Connie Silverman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427426014 PECOS PAC ID: 0749599900 Enrollment ID: I20151029000648 |
| Provider Name | Evan Rian Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275013997 PECOS PAC ID: 6002158003 Enrollment ID: I20190423000883 |
| Provider Name | Kathryn Maeve Mcgarry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528690450 PECOS PAC ID: 0840616694 Enrollment ID: I20200811003412 |
| Provider Name | Benjamin Sokoloff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831553858 PECOS PAC ID: 9133415508 Enrollment ID: I20201223000651 |
| Provider Name | Aimee Sprague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982929022 PECOS PAC ID: 6406160464 Enrollment ID: I20220114001590 |
| Provider Name | Kayla Rg Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912484726 PECOS PAC ID: 0143613596 Enrollment ID: I20220207001206 |
| Provider Name | Katherine Ann O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841668977 PECOS PAC ID: 6901254374 Enrollment ID: I20231122002691 |
| Provider Name | Beyah Jay Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588011415 PECOS PAC ID: 5092158741 Enrollment ID: I20240209000026 |
| Provider Name | Ian Schroeder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265977888 PECOS PAC ID: 2062856743 Enrollment ID: I20240221002436 |
| Provider Name | Yasmin Malik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194036814 PECOS PAC ID: 4284070962 Enrollment ID: I20240316000378 |
| Provider Name | Victoria Leigh Burgess |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811597685 PECOS PAC ID: 5890136816 Enrollment ID: I20240508002315 |
| Provider Name | Kelsey Miller |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669082061 PECOS PAC ID: 9032550074 Enrollment ID: I20240508002914 |
| Provider Name | Esther Leila Zack |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1558850636 PECOS PAC ID: 9335581750 Enrollment ID: I20240530000877 |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
Cascadia Behavioral Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9125 Sw 55th Ave, Portland, OR 97219 Phone: 503-238-0769 Fax: 503-477-4598 | |
Edwards Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St, Suite 1100, Portland, OR 97205 Phone: 503-222-0557 | |
Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
Cultivating A New Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 541-904-0468 | |
Tiffany Kettermann, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2926 Ne Flanders St Ste 3c, Portland, OR 97232 Phone: 971-270-0167 |