| Oregon Change Clinic, Llc | |
|
1817 Ne 6th Ave Portland OR 97212-3960 | |
| (909) 455-4838 | |
| Not Available |
| Full Name | Oregon Change Clinic, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1817 Ne 6th Ave, Portland, Oregon |
| Authorized Official Name and Position | Shannon Jones (OWNER/CEO) |
| Authorized Official Contact | 9094554838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oregon Change Clinic, Llc 1817 Ne 6th Avenue Portland OR 97212-3906 Ph: (503) 719-7985 | Oregon Change Clinic, Llc 1817 Ne 6th Ave Portland OR 97212-3960 Ph: (909) 455-4838 |
| NPI Number | 1881293215 |
|---|---|
| Provider Enumeration Date | 10/17/2020 |
| Last Update Date | 01/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881293215 | NPI | - | NPPES |
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