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PORTLAND ANXIETY CLINIC NPI 1033692991


NPI Information

NPI: 1033692991
Provider Name: PORTLAND ANXIETY CLINIC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1130 SW MORRISON ST STE 619
PORTLAND, OR
ZIP 97205
Phone: (503) 313-0028
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PORTLAND ANXIETY CLINIC is a mental health counselor in Portland, OR. PORTLAND ANXIETY CLINIC NPI is 1033692991. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1130 SW MORRISON ST STE 619
PORTLAND, OR
ZIP 97205-217
Phone: (503) 313-0028

The provider's authorized official is Jill Davidson .
The authorized official title is PSYCHOLOGIST / OWNER/ Owner and has the following contact phone number (503) 313-0028.

The enumeration date for this NPI number is 9/7/2018 and was last updated on 9/7/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental Health2247OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11841508553OTHEROREGONJILL DAVIDSON NPI

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.