MEDICARE: PAUL B PRICE PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	831294	NV

General Provider Information

NPI Number	:	1790578243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL B PRICE PMHNP-BC

Provider Business Mailing Address
First Line	:	555 SE MLK JR BLVD UNIT 105
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-2595
Country	:	US
Telephone Number	:	503-664-9451
Fax Number	:	503-386-3230

Provider Business Practice Location Address
First Line	:	2219 RIMLAND DR STE 346
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-8660
Country	:	US
Telephone Number	:	503-664-9451
Fax Number	:	503-386-3230

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2025
Last Update Date	:	05/27/2025

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