| Cognitive Care Medical Group | |
|
12901 Se 97th Ave Ste 105 Clackamas OR 97015-7902 | |
| (503) 912-4788 | |
| (503) 912-4787 |
| Full Name | Cognitive Care Medical Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12901 Se 97th Ave Ste 105, Clackamas, Oregon |
| Authorized Official Name and Position | Eric George Wight (MANAGER) |
| Authorized Official Contact | 5039124790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Care Medical Group 12901 Se 97th Ave Ste 105 Clackamas OR 97015-7902 Ph: (503) 912-4788 | Cognitive Care Medical Group 12901 Se 97th Ave Ste 105 Clackamas OR 97015-7902 Ph: (503) 912-4788 |
| NPI Number | 1770023186 |
|---|---|
| Provider Enumeration Date | 03/03/2017 |
| Last Update Date | 09/12/2018 |
| Medicare PECOS PAC ID | 6103101498 |
|---|---|
| Medicare Enrollment ID | O20170329001297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770023186 | NPI | - | NPPES |
| 500723541 | Medicaid | OR |
| Provider Name | Christopher L Thoen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316178106 PECOS PAC ID: 0446434385 Enrollment ID: I20110418000527 |
| Provider Name | Heather L Knott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194900084 PECOS PAC ID: 6204029994 Enrollment ID: I20121210000048 |
| Provider Name | Kimberly A Sabin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669676193 PECOS PAC ID: 8628313681 Enrollment ID: I20181219000784 |
| Provider Name | Kristen F Fernandez-kong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144714858 PECOS PAC ID: 8022436369 Enrollment ID: I20200917002535 |
Linda Heins, Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10001 Se Sunnyside Rd Ste 140, Clackamas, OR 97015 Phone: 503-653-5205 Fax: 503-653-5219 | |
Villeda's Tranquility Health Solutions, Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8800 Se Sunnyside Rd Ste 257s, Clackamas, OR 97015 Phone: 503-747-9502 Fax: 877-744-1853 | |
Northwest Family Psychology Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10121 Se Sunnyside Rd, Suite 300, Clackamas, OR 97015 Phone: 503-454-6834 | |
In-house Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10117 Se Sunnyside Rd # F1217, Clackamas, OR 97015 Phone: 503-740-1971 Fax: 503-771-2436 | |
In-house Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 11211 Se Sunnyside Rd, Clackamas, OR 97015 Phone: 503-740-1971 Fax: 503-771-2436 | |
Linda E Schmidt Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10001 Se Sunnyside Rd, Suite 140, Clackamas, OR 97015 Phone: 503-258-7675 Fax: 503-653-5219 | |
My Multicare Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10121 Se Sunnyside Rd Ste 300, Suite 300, Clackamas, OR 97015 Phone: 503-902-1105 Fax: 503-786-3896 |