Pacific Northwest Behavioral Health, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C2054 Issued in OR

Legal business name

PACIFIC NORTHWEST BEHAVIORAL HEALTH, LLC

Practice address

6519 SE Milwaukie Ave
Portland, OR 97202-5519

Phone

(971) 258-2120

Fax

(971) 200-2719

NPI assigned

Nov 18, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Alison Christine Gullion, LPCNPI 1164581245

Title

Business Owner

Phone

(971) 258-2120

Specialties & licenses 2

Addresses

Other names 1

• PNWBH Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alison C Gullion, MA

  • Counselor
  • Portland, OR
  • NPI 1164581245
  NPD (past) Authorized official
• Stephani G Grace, LPC

  • Case Manager/Care Coordinator
  • Portland, OR
  • NPI 1225426133

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1609206291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6519 SE MILWAUKIE AVENUE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97202",
            "telephone_number": "971-258-2120",
            "fax_number": "971-200-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6519 SE MILWAUKIE AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972025519",
            "telephone_number": "971-258-2120",
            "fax_number": "971-200-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "GULLION",
        "authorized_official_first_name": "ALISON",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "971-258-2120",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2054",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PNWBH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.