Pamela Self, is a medicare enrolled "Social Worker - Clinical" provider in Portland, Oregon. Her current practice location is
2415 Se 43rd Ave Ste 200, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 238-0705.
Pamela Self is licensed to practice in Oregon (license number L10482) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1851742175.
Healthcare Provider's Profile
Full Name | Pamela Self |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 2415 Se 43rd Ave Ste 200, Portland, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1851742175
- Provider Enumeration Date: 06/28/2016
- Last Update Date: 09/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 4284048422
- Enrollment ID: I20210128002227
Medical Identifiers
Medical identifiers for Pamela Self such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851742175 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 19-04-13 (Oregon) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | L10482 (Oregon) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Pamela Self allows following entities to bill medicare on her behalf.
Entity Name | Cascadia Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1336196401 PECOS PAC ID: 7618873761 Enrollment ID: O20031209000991 |
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Entity Name | Mindful Therapy Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1316238678 PECOS PAC ID: 4981872561 Enrollment ID: O20210301001586 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pamela Self is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Pamela Self, Po Box 8459, Portland, OR 97207-8459 Ph: () - | Pamela Self, 2415 Se 43rd Ave Ste 200, Portland, OR 97206-1671 Ph: (503) 238-0705 |
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