MEDICARE: PRECISION MENTAL PERFORMANCE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	207Q00000X	Family Medicine Physician
3	103T00000X	Psychologist
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	1041C0700X	Clinical Social Worker
6	2084P0800X	Psychiatry Physician
7	106H00000X	Marriage & Family Therapist
8	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316569502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION MENTAL PERFORMANCE LLC

Provider Business Mailing Address
First Line	:	2110 MISSION ST SE STE 305
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-0038
Country	:	US
Telephone Number	:	503-379-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 SE SANDY BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1399
Country	:	US
Telephone Number	:	503-379-1902
Fax Number	:

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	LAWRENCE K ROBBINS
Credential	:	RN
Telephone Number	:	503-379-1902

Provider Enumeration Date	:	05/11/2020
Last Update Date	:	09/12/2025

Similar Medicare Providers

1588051213 — MELANIE R BOURKE APRN, PMHNP
Practice Location Address:

975 SE SANDY BLVD STE 230
PORTLAND, OR
97214-1399

Practice Phone: 503-379-1902
Practice Fax: 503-334-1617

1427354240 — EBONY ASHLEY FLAHERTY
Practice Location Address:

975 SE SANDY BLVD # 100
PORTLAND, OR
97214-1399

Practice Phone: 503-805-7034
Practice Fax:

1326328626 — DEBORAH MEADORS LPC
Practice Location Address:

975 SE SANDY BLVD STE 100
PORTLAND, OR
97214-1399

Practice Phone: 503-427-1952
Practice Fax:

1720664592 — MRS. KATHLEEN GRACE CONVERSE
Practice Location Address:

975 SE SANDY BLVD STE 100
PORTLAND, OR
97214-1399

Practice Phone: 503-427-1952
Practice Fax:

1023770542 — REBECA ELISABET CATALAN
Practice Location Address:

975 SE SANDY BLVD STE 230
PORTLAND, OR
97214-1399

Practice Phone: 503-379-1902
Practice Fax:

1164240487 — TODD WERKHOVEN
Practice Location Address:

975 SE SANDY BLVD STE 100
PORTLAND, OR
97214-1399

Practice Phone: 503-427-1952
Practice Fax:

Directions to “PRECISION MENTAL PERFORMANCE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.