PORTLAND NEUROFEEDBACK LLC NPI 1558875476

NPI Information

NPI: 1558875476
Provider Name: PORTLAND NEUROFEEDBACK, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
4035 NE SANDY BLVD # 200
PORTLAND, OR
ZIP 97212
Phone: (971) 940-2601
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PORTLAND NEUROFEEDBACK, LLC is a mental health counselor in Portland, OR. PORTLAND NEUROFEEDBACK, LLC NPI is 1558875476. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4035 NE SANDY BLVD # 200
PORTLAND, OR
ZIP 97212-331
Phone: (971) 940-2601
Fax: (971) 275-1534

The provider's authorized official is Esther Cheers .
The authorized official title is Credentialing Coordinator and has the following contact phone number (971) 940-2601.

The enumeration date for this NPI number is 11/30/2017 and was last updated on 6/29/2021.

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	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health		OREGON	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500738886	MEDICAID	OREGON
2	5006392224	MEDICAID	OREGON

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

NPI Synchronization or Removal

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