| Stonewall Behavioral Health | |
|
826 Se 10th St Pendleton OR 97801-3246 | |
| (503) 503-9003 | |
| Not Available |
| Full Name | Stonewall Behavioral Health |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 826 Se 10th St, Pendleton, Oregon |
| Authorized Official Name and Position | Nathan T Smith (PRESIDENT) |
| Authorized Official Contact | 5416948189 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonewall Behavioral Health 826 Se 10th St Pendleton OR 97801-3246 Ph: (503) 503-9003 | Stonewall Behavioral Health 826 Se 10th St Pendleton OR 97801-3246 Ph: (503) 503-9003 |
| NPI Number | 1790653392 |
|---|---|
| Provider Enumeration Date | 10/27/2025 |
| Last Update Date | 10/27/2025 |
| Certification Date | 10/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790653392 | NPI | - | NPPES |
| 500820179 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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