SOMATIC CENTER PORTLAND LLC NPI 1104491349

NPI Information

NPI: 1104491349
Provider Name: SOMATIC CENTER PORTLAND LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
959 SE DIVISION ST STE 315
PORTLAND, OR
ZIP 97214
Phone: (971) 369-8690
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SOMATIC CENTER PORTLAND LLC is a mental health (including community mental health center) clinic center in Portland, OR. SOMATIC CENTER PORTLAND LLC NPI is 1104491349. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

959 SE DIVISION ST STE 315
PORTLAND, OR
ZIP 97214-673
Phone: (971) 369-8690

The provider's authorized official is Alissa D Bazinet .
The authorized official title is Clinical Psychologist and has the following contact phone number (619) 203-8403.

The enumeration date for this NPI number is 5/20/2021 and was last updated on 5/20/2021.

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	Primary
1	103TC0700X	Psychologist	Clinical	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry	No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	Yes

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: 4/28/2024

NPI Synchronization or Removal

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