Provider Demographics
NPI:1346802733
Name:COMPASS PSYCHIATRIC WELLNESS LLC
Entity Type:Organization
Organization Name:COMPASS PSYCHIATRIC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNEMIEKE
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:EMCH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:503-741-2735
Mailing Address - Street 1:15110 BOONES FERRY RD STE 248
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-3498
Mailing Address - Country:US
Mailing Address - Phone:503-741-2735
Mailing Address - Fax:503-308-7222
Practice Address - Street 1:15110 BOONES FERRY RD STE 248
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3498
Practice Address - Country:US
Practice Address - Phone:503-741-2735
Practice Address - Fax:503-308-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-05
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty