WEST LINN CLEMENTINE INC NPI 1023562147

NPI Information

  • NPI: 1023562147
  • Provider Name: WEST LINN CLEMENTINE, INC
  • Classification: Clinic/Center - 261QM0855X
  • Specialization: Adolescent and Children Mental Health
  • Entity Type: Organization
  • Doing Business As: CLEMENTINE PORTLAND
  • CLIA Number: 38D2316929
  • Address: 1148 ROSEMONT RD
    WEST LINN, OR
    ZIP 97068
  • Phone: (971) 249-8448

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NPI Details

WEST LINN CLEMENTINE, INC is an adolescent and children mental health clinic center in West Linn, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. WEST LINN CLEMENTINE, INC NPI is 1023562147. The provider is registered as an organization entity type.
The provider Is Doing Business As Clementine Portland.

The provider's business location address is:

1148 ROSEMONT RD
WEST LINN, OR
ZIP 97068-235
Phone: (971) 249-8448
Fax: (503) 305-7100

The provider's authorized official is Mike Bagley .
The authorized official title is Chief Financial Officer and has the following contact phone number (305) 663-1876.

The CLIA number assigned to this NPI record is 38D2316929 - other - its psych resident treat with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2016 and was last updated on 3/4/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthOREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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