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NPI Code Detail

MEDICARE: MS. SAMANTHA ALLISON MANDEL LPC

MEDICARE: MS. SAMANTHA ALLISON MANDEL LPC
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
1101YP2500XProfessional CounselorC6304OR

General Provider Information

NPI Number : 1679097091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SAMANTHA ALLISON MANDEL LPC
Provider Business Mailing Address
First Line : 9133 N ALLEGHENY AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-2303
Country : US
Telephone Number : 971-319-4827
Fax Number :
Provider Business Practice Location Address
First Line : 7704 N HEREFORD AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97203-3434
Country : US
Telephone Number : 971-319-4827
Fax Number : 503-662-6221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2017
Last Update Date : 03/25/2026

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