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NPI Code Detail

MEDICARE: PORTLAND DBT INSTITUTE, INC.

MEDICARE: PORTLAND DBT INSTITUTE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral Psychologist

General Provider Information

NPI Number : 1073853966
Entity Type Code : Organization
Provider Name (Legal Business Name) : PORTLAND DBT INSTITUTE, INC.
Provider Business Mailing Address
First Line : 5100 S MACADAM AVE STE 350
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3877
Country : US
Telephone Number : 503-231-7854
Fax Number : 503-231-8153
Provider Business Practice Location Address
First Line : 5100 S MACADAM AVE., STE 350
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3877
Country : US
Telephone Number : 503-231-7854
Fax Number : 503-231-8153
Authorized Official
Title or Position : BUSINESS ADMINISTRATOR
Name : TANNER SNELL
Credential :
Telephone Number : 971-339-3523
Provider Enumeration Date : 02/28/2013
Last Update Date : 02/24/2026

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