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General NPI Number Information
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NPI Number | 1730167982
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Entity Type | Organization
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Legal Business Name | SEQUOIA MENTAL HEALTH SERVICES INC
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 04/11/2013
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Provider Practice Location Address
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Address Line | 4585 SW 185TH AVE
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City | ALOHA
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State | OR
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Zip | 97007-1557
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Country | US
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Telephone | 503-591-9280
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Fax | 503-848-2072
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Provider Business Mailing Address
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Address Line | 4585 SW 185TH AVE
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City | ALOHA
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State | OR
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Zip | 97007-1557
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Country | US
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Telephone | 503-591-9280
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Fax | 503-848-2072
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAVID PUMP
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Credential |
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Telephone | 503-591-9280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OR
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