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1255977021
PORTLAND PSYCHIATRIC ALLIANCE LLC
PORTLAND, OR
NPI
1255977021
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Entity Type
Organization
Authorized Contact
TYLER CHIPMAN
Member
503-406-6515
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2019-11-26
Last Update Date
2019-11-26
Business Address
PORTLAND PSYCHIATRIC ALLIANCE LLC
3434 SW KELLY AVE
PORTLAND, OR 97239-4630
Phone number: 503-406-6515
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Mailing Address
PORTLAND PSYCHIATRIC ALLIANCE LLC
3434 SW KELLY AVE
PORTLAND, OR 97239-4630
Phone number: 503-406-6515
Copy
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