St Mary Health LLC

Primary specialty

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

Legal business name

ST MARY HEALTH LLC

Practice address

80 SE Madison St Ste 242
Portland, OR 97214-4527

Phone

(971) 242-4194

NPI assigned

Jul 12, 2023

Organization subpart

No

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

Authorized official

Name

Susan Evans

Title

Psy.D

Phone

(971) 242-4194

Specialties & licenses 2

Addresses

Other names 1

• St Mary Health Doing business as

Locations

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1720767254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 SE MADISON ST STE 242",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144527",
            "telephone_number": "971-242-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SE MADISON ST STE 242",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144527",
            "telephone_number": "971-242-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PSY.D",
        "authorized_official_telephone_number": "971-242-4194"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mary Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Mary Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Colleen Marie St John
• St Johns Dental Arts PC
• Margaret M St Louis, RDH
• Claire Elizabeth St Marie
• Jamie D St Mark, CRNA
• Krysta St Michell, MEDICAL STUDENT
• Kelsey Jordan St. Amand, PA-C, MPH
• St. Andrews Memory Care
• Jenna Lea St. Arnauld
• Leland St. Charles, PSY.D.

• 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 Dec 21, 2023; 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.