MEDICARE: UPPER CIRCLE 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	251S00000X	Community/Behavioral Health Agency	C1630	OR

General Provider Information

NPI Number	:	1700106515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPPER CIRCLE INC

Provider Business Mailing Address
First Line	:	1300 BOONE RD SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97306-1038
Country	:	US
Telephone Number	:	503-391-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 BOONE RD SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97306-1038
Country	:	US
Telephone Number	:	503-391-1300
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. BETH ANN DOYLE
Credential	:	LPC
Telephone Number	:	503-391-1300

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	06/03/2010

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Directions to “UPPER CIRCLE INC ” Practice Location

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