| Brave Acorn | |
|
1675 Sw Marlow Ave Suite 303 Portland OR 97225 | |
| (503) 709-5137 | |
| (503) 200-1198 |
| Full Name | Brave Acorn |
|---|---|
| Speciality | Social Worker |
| Location | 1675 Sw Marlow Ave, Portland, Oregon |
| Authorized Official Name and Position | Sarah C Alexander (OWNER) |
| Authorized Official Contact | 5037095137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave Acorn 1675 Sw Marlow Ave Ste 303 Portland OR 97225-5102 Ph: (503) 709-5137 | Brave Acorn 1675 Sw Marlow Ave Suite 303 Portland OR 97225 Ph: (503) 709-5137 |
| NPI Number | 1760971824 |
|---|---|
| Provider Enumeration Date | 05/04/2018 |
| Last Update Date | 08/18/2020 |
| Certification Date | 08/18/2020 |
| Medicare PECOS PAC ID | 8426475393 |
|---|---|
| Medicare Enrollment ID | O20200825000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760971824 | NPI | - | NPPES |
| 26-4409846 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 4301 (Oregon) | Primary |
| Provider Name | Sarah Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932340726 PECOS PAC ID: 6901085760 Enrollment ID: I20110125001081 |
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