Provider Demographics
NPI:1093168700
Name:SENIOR PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:SENIOR PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-906-7800
Mailing Address - Street 1:12725 SW MILLIKAN WAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1678
Mailing Address - Country:US
Mailing Address - Phone:503-906-7800
Mailing Address - Fax:
Practice Address - Street 1:12725 SW MILLIKAN WAY
Practice Address - Street 2:SUITE 300
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1678
Practice Address - Country:US
Practice Address - Phone:503-906-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty