| St Mary's Home For Boys | |
|
16535 Sw Tualatin Valley Hwy Beaverton OR 97006-5143 | |
| (503) 649-5651 | |
| (503) 649-7405 |
| Full Name | St Mary's Home For Boys |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 16535 Sw Tualatin Valley Hwy, Beaverton, Oregon |
| Authorized Official Name and Position | Michael Cole (ASSISTANT DIRECTOR) |
| Authorized Official Contact | 5032593201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Mary's Home For Boys 16535 Sw Tualatin Valley Hwy Beaverton OR 97006-5143 Ph: (503) 649-5651 | St Mary's Home For Boys 16535 Sw Tualatin Valley Hwy Beaverton OR 97006-5143 Ph: (503) 649-5651 |
| NPI Number | 1619057098 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 05/07/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619057098 | NPI | - | NPPES |
| 210855 | Medicaid | OR |
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