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General NPI Number Information
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NPI Number | 1639814882
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Entity Type | Organization
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Legal Business Name | NORTHSTAR COMMUNITY SERVICES INC
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 07/11/2023
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Provider Practice Location 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 | 971-297-1360
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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 | 971-297-1360
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | TRISHA 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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #7
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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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