CLEMENTINE PORTLAND
NPI 1023562147
Clinic/Center - Adolescent and Children Mental Health in West Linn, OR
NPI Status: Active since August 05, 2016
Contact Information
1148 ROSEMONT RD
WEST LINN, OR
ZIP 97068
Phone: (971) 249-8448
Fax: (503) 305-7100
- Organization
- Clinic/Center
- Adolescent and Children Mental Health
- Accepts Insurance
- CLIA Number: 38D2316929
- CLIA Cert. Type: Other - ITS PSYCH RESIDENT TREAT
- CLIA Exp. Date: 01-14-2027
About CLEMENTINE PORTLAND
This page provides the complete NPI Profile along with additional information for Clementine Portland, a provider established in West Linn, Oregon operating as a Clinic/center, focusing in adolescent and children mental health . The healthcare provider is registered in the NPI registry with number 1023562147 assigned on August 2016. The practitioner's primary taxonomy code is 261QM0855X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Clementine Portland. The authorized official of this NPI record is Mike Bagley (Chief Financial Officer)
- NPI
- 1023562147
- Provider Legal Name
- WEST LINN CLEMENTINE, INC
- Other Organization Name
- CLEMENTINE PORTLAND
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1148 ROSEMONT RD WEST LINN, OR 97068
- Location Phone
- (971) 249-8448
- Location Fax
- (503) 305-7100
- Mailing Address
- 6100 SW 76TH ST SOUTH MIAMI, FL 33143
- Mailing Phone
- (305) 663-1876
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-05-2016
- Last Update Date
- 03-04-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Adolescent and Children Mental Health
- Taxonomy Code
- 261QM0855X
- Type
- Ambulatory Health Care Facilities
- License State
- OR
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BridgeSpan Standard Bronze Plan - EPO
- BridgeSpan Standard Gold Plan - EPO
- BridgeSpan Standard Silver Plan - EPO
- KP OR Bronze 6000 - EPO
- KP OR Bronze HSA 7100 - EPO
- KP OR Gold 0 - EPO
- KP OR Gold 1750 - EPO
- KP OR Silver 3000 - EPO
- KP OR Silver 4000 - EPO
- KP Oregon Standard Bronze Plan - EPO
- KP Oregon Standard Gold Plan - EPO
- KP Oregon Standard Silver Plan - EPO
- KP OR Family Dental - $100 Ded - EPO
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Connect 1500 Gold - EPO
- Connect 6000 Silver - EPO
- Connect 9800 Bronze - EPO
- HSA Qualified 7500 Bronze - Choice Network - EPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Choice Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Choice Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Choice Network - EPO
- Bronze 8000 Individual Connect - EPO
- Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
- Bronze HSA 7000 Individual Connect - EPO
- Gold 2300 Individual Connect - EPO
- Regence Standard Bronze Plan Individual Connect - EPO
- Regence Standard Gold Plan Individual Connect - EPO
- Regence Standard Silver Plan Individual Connect - EPO
- Silver 6500 Individual Connect - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 38D2316929
- Facility Type
- Other - ITS PSYCH RESIDENT TREAT
- Certificate Effective Date
- January 15, 2025
- Certificate Expiration Date
- January 14, 2027
- Laboratory Director
- MOLLY M. PERLMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Clementine Portland to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for CLEMENTINE PORTLAND
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1023562147, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023562147, enumerated as an "organization" on August 05, 2016.
The provider is located at 1148 ROSEMONT RD WEST LINN, OR 97068 and the phone number is (971) 249-8448.
Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.
The provider might be accepting Accepts: BridgeSpan Health Company, Kaiser Permanente, Moda. Please consult your insurance carrier or call the provider to verify.
