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General NPI Number Information
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NPI Number | 1700256989
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Entity Type | Organization
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Legal Business Name | PACIFIC UNIVERSITY
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 222 SE 8TH AVE SUITE 212
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City | HILLSBORO
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State | OR
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Zip | 97123-4218
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Country | US
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Telephone | 503-352-7333
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Fax | 503-352-7250
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Provider Business Mailing Address
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Address Line | 222 SE 8TH AVE SUITE 212
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City | HILLSBORO
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State | OR
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Zip | 97123-4218
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Country | US
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Telephone | 503-352-7333
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Fax | 503-352-7250
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | MR. LISA DOWNING
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Credential |
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Telephone | 503-352-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 1476
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 1476
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License Number State | OR
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