Organization
COLUMBIACARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE DAVID SEWITSKY (FINANCE MANAGER)
(541) 858-8170
Entity
Organization
Contact information
Practice address
17640 NE HALSEY ST, PORTLAND, OR 97230-6733
(541) 858-8170
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/29/2014
Last updated
10/29/2014
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