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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