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Organization
ST MARY HEALTH LLC
Active
Organization
ST MARY HEALTH LLC
Active
Other names
St Mary Health
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN EVANS (PSY.D)
(971) 242-4194
Entity
Organization
Contact information
Practice address
80 SE MADISON ST STE 242, PORTLAND, OR 97214-4527
(971) 242-4194
Mailing address
80 SE MADISON ST STE 242, PORTLAND, OR 97214-4527
(971) 242-4194
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
12/21/2023
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