MEDICARE: RIO COUNSELING, 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	261QM0850X	Adult Mental Health Clinic/Center	C1476	OR

General Provider Information

NPI Number	:	1205099306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIO COUNSELING, INC.

Provider Business Mailing Address
First Line	:	6950 SW HAMPTON ST
Second Line	:	SUITE 319
City	:	PORTLAND
State	:	OR
Zip	:	97223-8329
Country	:	US
Telephone Number	:	503-816-2443
Fax Number	:	503-684-0620

Provider Business Practice Location Address
First Line	:	6950 SW HAMPTON ST
Second Line	:	SUITE 319
City	:	PORTLAND
State	:	OR
Zip	:	97223-8329
Country	:	US
Telephone Number	:	503-816-2443
Fax Number	:	503-684-0620

Authorized Official
Title or Position	:	COUNSELOR
Name	:	JEFFREY D. OBERMEIER
Credential	:	MA, LPC
Telephone Number	:	503-816-2443

Provider Enumeration Date	:	07/08/2008
Last Update Date	:	07/08/2008

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