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General NPI Number Information
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NPI Number | 1538782834
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Entity Type | Organization
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Legal Business Name | ENDEAVOR PSYCHIATRY, LLC
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | SW
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City | PORTLAND
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State | OR
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Zip | 97219-5885
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Country | US
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Telephone | 971-238-6143
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Fax |
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Provider Business Mailing Address
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Address Line | 9220 SW BARBUR BLVD. SUITE 119, NUMBER 75
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City | PORTLAND
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State | OR
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Zip | 97219-5428
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Country | US
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Telephone | 503-420-7472
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Fax | 956-394-1074
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Authorized Official
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Title or Position | CEO
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Name | PAUL J MCMAHON
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Credential |
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Telephone | 503-420-7472
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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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