| Providence Behavioral Health Outpatient West | |
|
9450 Sw Barnes Rd Suite 200 Portland OR 97225-6619 | |
| (503) 216-2089 | |
| Not Available |
| Full Name | Providence Behavioral Health Outpatient West |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 9450 Sw Barnes Rd, Portland, Oregon |
| Authorized Official Name and Position | Mitchell Neyhart (CHIEF FINANCE OFFICER) |
| Authorized Official Contact | 5035749840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Behavioral Health Outpatient West Po Box 3158 Portland OR 97208-3158 Ph: () - | Providence Behavioral Health Outpatient West 9450 Sw Barnes Rd Suite 200 Portland OR 97225-6619 Ph: (503) 216-2089 |
| NPI Number | 1568660900 |
|---|---|
| Provider Enumeration Date | 07/06/2007 |
| Last Update Date | 04/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568660900 | NPI | - | NPPES |
| 278979 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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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 | |
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