ST MARY HEALTH - NPI 1720767254 - Clinic/Center in Portland, OR

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).

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About St Mary Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST MARY HEALTH (NPI 1720767254) is a healthcare organization registered as a mental health (including community mental health center) in Portland, Oregon and active in the NPI registry since July 2023. The organization lists Susan Evans, Psy.d, as its authorized official.

NPPES Registry Identity

NPI1720767254

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameST MARY HEALTH LLC

Location Address80 SE MADISON ST STE 242Portland, OR 97214-4527

Mailing Address80 Se Madison St Ste 242Portland, OR 97214-4527 · (971) 242-4194

Phone(971) 242-4194

Organization SubpartNo

Authorized OfficialSusan EvansPsy.d · (971) 242-4194

Enumeration DateJuly 12, 2023

Last NPPES UpdateDecember 21, 20235 updates tracked since enumeration

NPPES CertifiedDecember 21, 2023

✔ NPI 1720767254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

80 SE MADISON ST STE 242, Portland, OR 97214

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Other Names 1

Doing Business AsSt Mary Health

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLEMENT MUCYO

Peer Specialist