| Well Coast Psychiatric | |
|
10260 Sw Greenburg Rd Fl 4 Tigard OR 97223-5500 | |
| (888) 923-5486 | |
| (866) 225-9111 |
| Full Name | Well Coast Psychiatric |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10260 Sw Greenburg Rd Fl 4, Tigard, Oregon |
| Authorized Official Name and Position | Erik Lee (OWNER) |
| Authorized Official Contact | 8889235486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Well Coast Psychiatric 11575 Sw Pacific Hwy # 40452 Tigard OR 97223-8671 Ph: (888) 923-5486 | Well Coast Psychiatric 10260 Sw Greenburg Rd Fl 4 Tigard OR 97223-5500 Ph: (888) 923-5486 |
| NPI Number | 1841784725 |
|---|---|
| Provider Enumeration Date | 06/14/2018 |
| Last Update Date | 07/17/2022 |
| Certification Date | 07/17/2022 |
| Medicare PECOS PAC ID | 4789928433 |
|---|---|
| Medicare Enrollment ID | O20181206000926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841784725 | NPI | - | NPPES |
| 1699110890 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | NP95002431 (California) | Secondary |
| Provider Name | Erik Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699110890 PECOS PAC ID: 0143537746 Enrollment ID: I20150915001130 |
| Provider Name | Jonathan Wayne May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629620497 PECOS PAC ID: 4688003072 Enrollment ID: I20200714003878 |
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