| An Inner Guide Llc | |
|
161 High St Se Ste 204 Salem OR 97301-3610 | |
| (503) 749-0306 | |
| (503) 749-0343 |
| Full Name | An Inner Guide Llc |
|---|---|
| Speciality | Social Worker |
| Location | 161 High St Se Ste 204, Salem, Oregon |
| Authorized Official Name and Position | Ka Rin Kay Johnson (OWNER) |
| Authorized Official Contact | 5035800611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| An Inner Guide Llc 161 High St Se Ste 204 Salem OR 97301-3610 Ph: (503) 749-0306 | An Inner Guide Llc 161 High St Se Ste 204 Salem OR 97301-3610 Ph: (503) 749-0306 |
| NPI Number | 1043939887 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 10/13/2022 |
| Certification Date | 10/13/2022 |
| Medicare PECOS PAC ID | 9032580485 |
|---|---|
| Medicare Enrollment ID | O20230120002529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043939887 | NPI | - | NPPES |
| 500688153 | Medicaid | OR |
| Provider Name | Ka Rin Kay Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811379480 PECOS PAC ID: 0840661294 Enrollment ID: I20230120002600 |
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