| Cornerstone Clinical Services Pc | |
|
6400 Se Lake Rd Ste 325 Milwaukie OR 97222-2185 | |
| (503) 786-1711 | |
| (503) 786-9919 |
| Full Name | Cornerstone Clinical Services Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6400 Se Lake Rd Ste 325, Milwaukie, Oregon |
| Authorized Official Name and Position | Diane L Strong (OFFICE MANAGER) |
| Authorized Official Contact | 5037861711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Clinical Services Pc 6400 Se Lake Rd Ste 325 Milwaukie OR 97222-2185 Ph: (503) 786-1711 | Cornerstone Clinical Services Pc 6400 Se Lake Rd Ste 325 Milwaukie OR 97222-2185 Ph: (503) 786-1711 |
| NPI Number | 1093892895 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 09/26/2007 |
| Medicare PECOS PAC ID | 3274523378 |
|---|---|
| Medicare Enrollment ID | O20040512000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093892895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Alan S Yeo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417983628 PECOS PAC ID: 3577556943 Enrollment ID: I20040403000290 |
| Provider Name | Timothy A Perkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336171313 PECOS PAC ID: 2769472869 Enrollment ID: I20040513000011 |
| Provider Name | Mark D Nordlund |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609808724 PECOS PAC ID: 7618967712 Enrollment ID: I20040513000050 |
| Provider Name | Annette G Gilmore Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730111279 PECOS PAC ID: 0143210153 Enrollment ID: I20040513000148 |
| Provider Name | James C Putman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306861737 PECOS PAC ID: 0244220341 Enrollment ID: I20040615001847 |
| Provider Name | Philip M Bolton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588692388 PECOS PAC ID: 0143280602 Enrollment ID: I20041019000332 |
| Provider Name | Laura A Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750313060 PECOS PAC ID: 0648260745 Enrollment ID: I20050202000172 |
| Provider Name | Peter F Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992897490 PECOS PAC ID: 3476598699 Enrollment ID: I20050628000158 |
| Provider Name | Y Pritham Raj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972690923 PECOS PAC ID: 8325047814 Enrollment ID: I20061211000419 |
| Provider Name | Matthew R Sleasman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326071937 PECOS PAC ID: 3678573573 Enrollment ID: I20061227000155 |
| Provider Name | Kerry Em Phifer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447336037 PECOS PAC ID: 5991883449 Enrollment ID: I20080423000645 |
| Provider Name | Kelli L Pellegrini |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477677730 PECOS PAC ID: 9234277435 Enrollment ID: I20091109000480 |
| Provider Name | Sarah L Landrey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083833438 PECOS PAC ID: 6204934813 Enrollment ID: I20120726000379 |
| Provider Name | Sheryl Lynn Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447693684 PECOS PAC ID: 1951548965 Enrollment ID: I20130511000045 |
| Provider Name | Michelle C Lown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619042082 PECOS PAC ID: 9830338664 Enrollment ID: I20130626000677 |
| Provider Name | Shaun L Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699240184 PECOS PAC ID: 9133464910 Enrollment ID: I20181226000626 |
| Provider Name | Daniel Alfonso Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437515962 PECOS PAC ID: 4587082680 Enrollment ID: I20200921002967 |
| Provider Name | Dawn M Hoffman-gray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588697197 PECOS PAC ID: 3476973702 Enrollment ID: I20201026001498 |
| Provider Name | Alycia Faith Ernst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104237700 PECOS PAC ID: 3577968437 Enrollment ID: I20210816003889 |
| Provider Name | Kyle Thomas Webster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649788217 PECOS PAC ID: 5890171318 Enrollment ID: I20221005003470 |
| Provider Name | Joanna Harberts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114122942 PECOS PAC ID: 2264889096 Enrollment ID: I20231115002497 |
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