Columbiacare Services
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Portland, OR
NPI 1982140588 · NPPES record last updated Jan 9, 2017
Key facts
- NPI
- 1982140588
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- COLUMBIACARE SERVICES
- Practice address
- 17720 NE Halsey St # 1
Portland, OR 97230-6734 - Phone
- (541) 858-8170
- Fax
- (541) 858-8167
- NPI assigned
- Jan 6, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Mike David Sewitsky
- Title
- Finance Manager
- Phone
- (541) 858-8170
Other NPIs on the same Medicare enrollment 32
Practitioners 689
-
Mollie Carlson Page, P.A.
-
Melissa Troy, LCSW
-
Angela Therese Arledge, LCSW
-
Justice Timothy Arledge, LPC-ASSOCIATE
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170420001277 | OR | Part B Supplier - Clinic/Group Practice | 6901182229 |
Receives reassigned benefits from 15 practitioners 32 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Medford, OR |
National Provider Directory
Locations
2222 Coburg Rd
Ste 100
Eugene, OR 97401
Phone (458) 210-2984
29413 Russell St
Gold Beach, OR 97444
Phone (541) 247-6566
100 E Main St
Ste Cn
Medford, OR 97501
Phone (541) 200-2900
1592 Monroe St
North Bend, OR 97459
Phone (541) 756-0248
2575 Westgate
#3
Pendleton, OR 97801
Phone (541) 276-6330
17720 NE Halsey St
#1
Portland, OR 97230
Phone (503) 654-7654
17640 NE Halsey St
Portland, OR 97230
Phone (503) 489-5045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
17720 NE Halsey St # 1
Portland, OR 97230-6734
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170
Other providers in Portland, OR
- Columbiacare Services
- Columbiacare Services
- Columbiacare Services
- Columbiacare Services
- Columbiacare Services
- Columbiacare Services Inc
- Aaron Michael Colvin
- Audrey Colvin
- Kayla Colvin
- Alyssa Covelli Colwill
All providers in Portland, OR · Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.