MEDICARE: MICHELLE VOEGELS, PMHNP, 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	200150014NP	OR

General Provider Information

NPI Number	:	1194066571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE VOEGELS, PMHNP, INC

Provider Business Mailing Address
First Line	:	2250 NW FLANDERS ST STE 101
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-5409
Country	:	US
Telephone Number	:	503-227-4374
Fax Number	:	503-227-4603

Provider Business Practice Location Address
First Line	:	2250 NW FLANDERS ST STE 101
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97210-5409
Country	:	US
Telephone Number	:	503-227-4374
Fax Number	:	503-227-4603

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	MRS. MICHELLE VOEGELS
Credential	:	PMHNP
Telephone Number	:	503-227-4374

Provider Enumeration Date	:	03/08/2013
Last Update Date	:	03/08/2013

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