PORTLAND STATE UNIVERSITY CENTER FOR STUDENT HEALTH AND COUNSELING NPI 1215072228

NPI Information

PORTLAND STATE UNIVERSITY CENTER FOR STUDENT HEALTH AND COUNSELING is a student health clinic center in Portland, OR. PORTLAND STATE UNIVERSITY CENTER FOR STUDENT HEALTH AND COUNSELING NPI is 1215072228. The provider is registered as an organization entity type.

The provider's business location address is:

1880 SW 6TH AVE
SUITE 200
PORTLAND, OR
ZIP 97201-204
Phone: (503) 725-2800
Fax: (503) 725-5812

The provider's authorized official is Mark Michael Bajorek .
The authorized official title is Medical Director and has the following contact phone number (503) 725-2800.

The CLIA number assigned to this NPI record is 38D2200873 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 6/24/2008.

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:

Other Identifiers

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

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