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Organization
NORTHCOAST CLINIC LLC
Active
Organization
NORTHCOAST CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY HEMSLEY (CEO)
(503) 791-3499
Entity
Organization
Contact information
Practice address
441 30TH ST, ASTORIA, OR 97103-2807
(503) 568-7497
Mailing address
441 30TH ST, ASTORIA, OR 97103-2807
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
NULL
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
NULL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
NULL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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