| Telecare Act-oregon | |
|
4101 Ne Division St Suite 100 Gresham OR 97030-4617 | |
| (503) 666-3808 | |
| (503) 666-6835 |
| Full Name | Telecare Act-oregon |
|---|---|
| Speciality | Clinic/Center |
| Location | 4101 Ne Division St, Gresham, Oregon |
| Authorized Official Name and Position | Leslie Davis (SVP, CFO) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare Act-oregon 1080 Marina Village Pkwy Suite 100 Alameda CA 94501-6427 Ph: (503) 666-6575 | Telecare Act-oregon 4101 Ne Division St Suite 100 Gresham OR 97030-4617 Ph: (503) 666-3808 |
| NPI Number | 1386767176 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 02/11/2020 |
| Certification Date | 02/11/2020 |
| Medicare PECOS PAC ID | 1557460524 |
|---|---|
| Medicare Enrollment ID | O20070618000058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386767176 | NPI | - | NPPES |
| 274147 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ben C Jew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275636680 PECOS PAC ID: 4880692383 Enrollment ID: I20061116000472 |
| Provider Name | Wil C Berry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174840615 PECOS PAC ID: 2769631928 Enrollment ID: I20140728002310 |
| Provider Name | Lyle Lester Jobe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912963299 PECOS PAC ID: 3971492182 Enrollment ID: I20150708001640 |
| Provider Name | Michele T Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629494018 PECOS PAC ID: 7810111838 Enrollment ID: I20160610000122 |
| Provider Name | Anne E Linton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003522319 PECOS PAC ID: 5395119069 Enrollment ID: I20230320002003 |
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Jordana Krueger-toscher, Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 N Main Ave Ste 201b, Gresham, OR 97030 Phone: 971-270-0741 Fax: 757-257-7460 | |
Born To Thrive Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 635 Se Juniper Ct E, Gresham, OR 97080 Phone: 971-274-1419 | |
Center Of Hope Counseling Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 510 Ne Roberts Ave Ste 100, Gresham, OR 97030 Phone: 971-284-9529 | |
New Pattern Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1584 Ne 8th St Ste 200, Gresham, OR 97030 Phone: 503-250-1401 | |
Main Psychology Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 N Main Ave, Gresham, OR 97030 Phone: 971-328-1794 | |
Pacific Northwest Home Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1124 Ne Burnside Rd, Gresham, OR 97030 Phone: 503-512-9358 |