MEDICARE: POSCIMUR LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1720771355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POSCIMUR LLC

Provider Business Mailing Address
First Line	:	19265 SE STARK ST STE B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97233-5758
Country	:	US
Telephone Number	:	503-755-8988
Fax Number	:	503-715-4943

Provider Business Practice Location Address
First Line	:	19265 SE STARK ST STE B
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97233-5758
Country	:	US
Telephone Number	:	503-755-8988
Fax Number	:	503-715-4943

Authorized Official
Title or Position	:	OWNER
Name	:	ALINA GRIMSTED
Credential	:	LCSW
Telephone Number	:	503-755-8988

Provider Enumeration Date	:	05/30/2023
Last Update Date	:	05/06/2024

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