| Randi Weber, Lpc Pc | |
|
4800 S Macadam Ave Ste 350 Portland OR 97239-3970 | |
| (503) 684-7948 | |
| (503) 715-1830 |
| Full Name | Randi Weber, Lpc Pc |
|---|---|
| Speciality | Counselor |
| Location | 4800 S Macadam Ave Ste 350, Portland, Oregon |
| Authorized Official Name and Position | Randi Weber Thoma (PRESIDENT) |
| Authorized Official Contact | 5036847948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randi Weber, Lpc Pc 4800 S Macadam Ave Ste 350 Portland OR 97239-3970 Ph: (503) 684-7948 | Randi Weber, Lpc Pc 4800 S Macadam Ave Ste 350 Portland OR 97239-3970 Ph: (503) 684-7948 |
| NPI Number | 1386418457 |
|---|---|
| Provider Enumeration Date | 11/09/2023 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 7517310758 |
|---|---|
| Medicare Enrollment ID | O20240124002609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386418457 | NPI | - | NPPES |
| 1013001692 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Randi Weber Thoma |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013001692 PECOS PAC ID: 8426401662 Enrollment ID: I20240124002911 |
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