Provider Demographics
NPI:1477232122
Name:SAM-U-L, LLC
Entity Type:Organization
Organization Name:SAM-U-L, LLC
Other - Org Name:GIVING HOPE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:503-871-5078
Mailing Address - Street 1:12655 SW HARLEQUIN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6239
Mailing Address - Country:US
Mailing Address - Phone:971-777-3319
Mailing Address - Fax:
Practice Address - Street 1:12655 SW HARLEQUIN DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6239
Practice Address - Country:US
Practice Address - Phone:971-777-3319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty