Neuropsychological Services Of Oregon, Llc | |
231 Sw Scalehouse Loop Ste 203 Bend OR 97702-1277 | |
(541) 306-6456 | |
(541) 647-1580 |
Full Name | Neuropsychological Services Of Oregon, Llc |
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Speciality | Clinical Neuropsychologist |
Location | 231 Sw Scalehouse Loop Ste 203, Bend, Oregon |
Authorized Official Name and Position | Tracy Kreiling (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5413066456 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Neuropsychological Services Of Oregon, Llc 231 Sw Scalehouse Loop Ste 203 Bend OR 97702-1277 Ph: (541) 306-6456 | Neuropsychological Services Of Oregon, Llc 231 Sw Scalehouse Loop Ste 203 Bend OR 97702-1277 Ph: (541) 306-6456 |
NPI Number | 1164820478 |
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Provider Enumeration Date | 12/18/2014 |
Last Update Date | 10/17/2018 |
Medicare PECOS PAC ID | 1658697701 |
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Medicare Enrollment ID | O20150306002286 |
Identifier | Type | State | Issuer |
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1164820478 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103G00000X | Clinical Neuropsychologist | 2524 (Oregon) | Primary |
103T00000X | Psychologist | 2524 (Oregon) | Secondary |
Provider Name | Tracy N Kreiling |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1659682177 PECOS PAC ID: 8123212701 Enrollment ID: I20150306002291 |
Provider Name | Andrea Marie Jackson |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1194255877 PECOS PAC ID: 7719216431 Enrollment ID: I20190905003099 |
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