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PACIFIC UNIVERSITY NPI 1912377193


NPI Information

NPI: 1912377193
Provider Name: PACIFIC UNIVERSITY

Doing Business As: PACIFIC PSYCHOLOGY & COMPREHENSIVE HEALTH CLINIC

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
1411 SW MORRISON ST
SUTIE 310
PORTLAND, OR
ZIP 97205
Phone: (503) 352-2400
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PACIFIC UNIVERSITY is an adult mental health clinic center in Portland, OR. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. PACIFIC UNIVERSITY NPI is 1912377193. The provider is registered as an organization entity type.
The provider Is Doing Business As Pacific Psychology & Comprehensive Health Clinic.

The provider's business location address is:

1411 SW MORRISON ST
SUTIE 310
PORTLAND, OR
ZIP 97205-945
Phone: (503) 352-2400
Fax: (503) 352-2403

The provider's authorized official is Lisa Downing .
The authorized official title is Compliance Officer and has the following contact phone number (503) 352-2663.

The enumeration date for this NPI number is 10/1/2015 and was last updated on 11/14/2023.


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
1261QM0855XClinic/CenterAdolescent and Children Mental Health1476OREGONNo
2261QM0850XClinic/CenterAdult Mental Health1476OREGONYes

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
1500694103MEDICAIDOREGON

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

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