Active NPI
Pacific Mental Health Oregon LLC
- Counselor
- Portland, OR
National Provider Identifier
1811776933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Legal business name
- PACIFIC MENTAL HEALTH OREGON LLC
- Practice address
- 830 NE Holladay St
Portland, OR 97232-2104 - Phone
- (425) 582-2041
- Fax
- (425) 527-0468
- NPI assigned
- Sep 27, 2023
- Organization subpart
- Yes
- Parent organization
- PACIFIC MENTAL HEALTH LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeffery Goff
- Title
- Ceo Owner
- Phone
- (425) 361-2273
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
830 NE Holladay St
Portland, OR 97232-2104
Mailing address
5108 196TH St SW
Lynnwood, WA 98036-6152
National Provider Directory
National Provider Directory- Part of
- Pacific Mental Health LLC
Locations
5108 196th St SW
Lynnwood, WA 98036
Phone (425) 582-2041
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Lynnwood, WA
- NPI 1356796940
-
- Clinical Social Worker
- Seattle, WA
- NPI 1558101535
-
- Clinical Social Worker
- Lynnwood, WA
- NPI 1447011101
-
- Student in an Organized Health Care Education/Training Program
- Lynnwood, WA
- NPI 1225960792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695772800000",
"number": "1811776933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5108 196TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980366152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 NE HOLLADAY ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322104",
"telephone_number": "425-582-2041",
"fax_number": "425-527-0468"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PACIFIC MENTAL HEALTH OREGON LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PACIFIC MENTAL HEALTH LLC",
"enumeration_date": "2023-09-27",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A",
"authorized_official_last_name": "GOFF",
"authorized_official_first_name": "JEFFERY",
"authorized_official_title_or_position": "CEO OWNER",
"authorized_official_telephone_number": "425-361-2273"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
- Pacific Heart Associates, P.C.
- Pacific Heart Associates, P.C.
- Pacific Imaging Associates LLC
- Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)
- Pacific Mental Health Clinic LLC
- Pacific Neurosurgical PC
- Pacific Northwest Acupuncture&Herbal Clinic,LLC
- Pacific Northwest Behavioral Health, LLC (Pnwbh)
- Pacific Northwest Oncology Services
- Pacific Northwest Psychological Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.