Pacnorthwest Counseling

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PACNORTHWEST COUNSELING

Practice address

6018 SE Stark St
Portland, OR 97215-1990

Phone

(503) 730-5760

NPI assigned

Nov 19, 2019

Last updated

Nov 19, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Collin Davidson, LCSW

Title

Licensed Clinical Social Worker

Phone

(503) 730-5760

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1174169890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1677",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970241677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6018 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151990",
            "telephone_number": "503-730-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACNORTHWEST COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "503-730-5760",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Packard, L.M.T.
• Daniel N Packard, DO
• Darren John Packard, SLP
• Linda Dee Packard, L.P.C.
• Christine Packett Buchiarelli, LAC
• Margo Cohn Pactanac, LCSW
• Rachel Paczkowski
• Leah K Padaca, ATC
• Kiran Devram Padale
• Rheanna Jewel Padayhag

• Mental Health Clinic/Center (Including Community Mental Health Center) in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.