Provider Demographics
NPI:1023745239
Name:ANNE EMMETT THERAPY LLC
Entity type:Organization
Organization Name:ANNE EMMETT THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:EMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-238-2405
Mailing Address - Street 1:PO BOX 11860
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-0860
Mailing Address - Country:US
Mailing Address - Phone:503-238-0240
Mailing Address - Fax:888-974-3958
Practice Address - Street 1:1020 SW TAYLOR ST STE 560
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2533
Practice Address - Country:US
Practice Address - Phone:503-238-2405
Practice Address - Fax:888-974-3958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1215904370OtherNPI