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NPI Code Detail

MEDICARE: JOHN CHARLES COMBS SNOW

MEDICARE: JOHN CHARLES COMBS SNOW
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1689525057
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN CHARLES COMBS SNOW
Provider Business Mailing Address
First Line : 3415 SE POWELL BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97202-3371
Country : US
Telephone Number : 503-234-9591
Fax Number :
Provider Business Practice Location Address
First Line : 4455 NE HIGHWAY 20
Second Line :
City : CORVALLIS
State : OR
Zip : 97330-9695
Country : US
Telephone Number : 541-758-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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