Organization
TELEMENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH PORTER MSSM (OWNER, TECHNOLOGY MANAGER)
(541) 896-1555
Entity
Organization
Contact information
Practice address
5305 RIVER RD N STE B, KEIZER, OR 97303-5324
(541) 896-1555
Mailing address
65 DIVISION AVE UNIT 299, EUGENE, OR 97404-2485
(541) 896-1555
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
05/20/2021
Last updated
05/21/2021
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