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General NPI Number Information
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NPI Number | 1316755481
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Entity Type | Organization
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Legal Business Name | NORTHSTAR TMS
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 914 MAIN ST
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City | VANCOUVER
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State | WA
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Zip | 98660-3136
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Country | US
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Telephone | 503-878-8885
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Fax |
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Provider Business Mailing Address
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Address Line | 65 SW YAMHILL ST STE 300
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City | PORTLAND
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State | OR
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Zip | 97204-3316
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Country | US
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Telephone | 503-878-8885
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TRISHA SOPHIA MARIE JONES
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Credential |
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Telephone | 503-523-0296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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