| Pearl Health Center,pc | |
|
721 Nw 9th Ave Ste 100a Portland OR 97209-3477 | |
| (503) 525-0090 | |
| (971) 244-0219 |
| Full Name | Pearl Health Center,pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 721 Nw 9th Ave Ste 100a, Portland, Oregon |
| Authorized Official Name and Position | Shari S Freshman House (PRESIDENT,NURSE PRACTITIONER) |
| Authorized Official Contact | 5035250090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pearl Health Center,pc 721 Nw 9th Ave Ste 100a Portland OR 97209-3477 Ph: (503) 525-0090 | Pearl Health Center,pc 721 Nw 9th Ave Ste 100a Portland OR 97209-3477 Ph: (503) 525-0090 |
| NPI Number | 1104918275 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0143287243 |
|---|---|
| Medicare Enrollment ID | O20041209001096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104918275 | NPI | - | NPPES |
| 027741 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Oregon) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 363LFOOOOX (Oregon) | Primary |
| Provider Name | David W Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366686537 PECOS PAC ID: 5193905537 Enrollment ID: I20110202000418 |
| Provider Name | Sheila M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053379479 PECOS PAC ID: 3072530534 Enrollment ID: I20130415000499 |
| Provider Name | Whitney R. Ault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649674961 PECOS PAC ID: 2062634983 Enrollment ID: I20141110001224 |
| Provider Name | Marianne D Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710930987 PECOS PAC ID: 6709897192 Enrollment ID: I20150930003257 |
| Provider Name | Robert H Birkhahn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366497455 PECOS PAC ID: 9133144405 Enrollment ID: I20170222002382 |
| Provider Name | Amisha D Parekh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982900759 PECOS PAC ID: 6901064955 Enrollment ID: I20180126000484 |
| Provider Name | Katie S Strawn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346759628 PECOS PAC ID: 9032479357 Enrollment ID: I20180207000209 |
| Provider Name | Nicholi H Khajavei |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689186843 PECOS PAC ID: 1355602004 Enrollment ID: I20180227002090 |
| Provider Name | David J Klarberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922367044 PECOS PAC ID: 4082855523 Enrollment ID: I20190225002086 |
| Provider Name | Melanie L Anthony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811470149 PECOS PAC ID: 0042547002 Enrollment ID: I20190814000317 |
| Provider Name | Valerie A Brand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609464676 PECOS PAC ID: 1355759416 Enrollment ID: I20210719003418 |
| Provider Name | Renee Denise Storm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144991381 PECOS PAC ID: 8729476247 Enrollment ID: I20211102000976 |
| Provider Name | Summer M Massina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003303165 PECOS PAC ID: 8729343447 Enrollment ID: I20230222001242 |
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