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CONNIE ELDRIDGE-PEDERSON PHD PC NPI 1740420603


NPI Information

NPI: 1740420603
Provider Name: CONNIE ELDRIDGE-PEDERSON, PHD, PC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1611 NE 16TH AVE
PORTLAND, OR
ZIP 97232
Phone: (503) 287-4426
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CONNIE ELDRIDGE-PEDERSON, PHD, PC is a community behavioral health in Portland, OR. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CONNIE ELDRIDGE-PEDERSON, PHD, PC NPI is 1740420603. The provider is registered as an organization entity type.

The provider's business location address is:

1611 NE 16TH AVE
PORTLAND, OR
ZIP 97232-413
Phone: (503) 287-4426
Fax: (503) 284-6051

The provider's authorized official is Connie Eldridge-pederson .
The authorized official title is President and has the following contact phone number (503) 287-4426.

The enumeration date for this NPI number is 3/4/2009 and was last updated on 3/17/2009.


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
1251S00000XCommunity/Behavioral Health1070OREGONYes

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

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