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Organization
PACIFIC MENTAL HEALTH CLINIC LLC
Active
Organization
PACIFIC MENTAL HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KADRA ABDULLAHI MOHAMED RN (OWNER)
(206) 489-8775
Entity
Organization
Contact information
Practice address
16323 SE STARK ST STE 102, PORTLAND, OR 97233-3942
(503) 265-8922
(971) 420-2990
Mailing address
16323 SE STARK ST STE 102, PORTLAND, OR 97233-3942
(503) 265-8922
(971) 420-2990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
03/21/2024
Last updated
02/24/2026
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