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NPI 1992471676

NPI 1992471676 : NEUPATHWAY LLC : BEAVERTON, OR

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General NPI Number Information
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    NPI Number           |    1992471676
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    Entity Type          |    Organization 
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    Legal Business Name  |    NEUPATHWAY LLC 
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Dates
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    Enumeration Date     |    08/21/2021
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    Last Update Date     |    11/10/2023
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Provider Practice Location Address
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    Address Line         |    12725 SW MILLIKAN WAY STE 300 
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    City                 |    BEAVERTON
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    State                |    OR
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    Zip                  |    97005-1687
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    Country              |    US
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    Telephone            |    971-319-1592
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    Fax                  |    971-999-0925
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Provider Business Mailing Address
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    Address Line         |    12725 SW MILLIKAN WAY STE 300 
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    City                 |    BEAVERTON
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    State                |    OR
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    Zip                  |    97005-1687
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    Country              |    US
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    Telephone            |    971-319-1592
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    Fax                  |    971-999-0925
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. GABRIEL  TAYLOR-PARSONS 
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    Credential           |    APRN
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    Telephone            |    971-319-1592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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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        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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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        |    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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