Organization
INTERCULTUAL PSYCHIATRIC PROGAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMBIKA KAPHLE QMHA (QUALIFIED MENTAL HEALTH ASSOCIATE)
(503) 418-5063
Entity
Organization
Contact information
Practice address
3633 SE 35TH PLACE, PORTLAND, OR 97202
(503) 418-5063
Mailing address
3633 SE 35TH PLACE, PORLTAND, OR 97202
(503) 418-5063
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
01301974
OR
Other
Enumeration date
07/15/2009
Last updated
07/15/2009
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