Provider Demographics
NPI:1841772233
Name:PSYCHIATRIST ON-CALL, LLC
Entity Type:Organization
Organization Name:PSYCHIATRIST ON-CALL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-880-6414
Mailing Address - Street 1:12655 SW CENTER ST STE 150
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-1864
Mailing Address - Country:US
Mailing Address - Phone:503-832-0945
Mailing Address - Fax:
Practice Address - Street 1:12655 SW CENTER ST STE 150
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-1864
Practice Address - Country:US
Practice Address - Phone:503-832-0945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMAS HOLDING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1650762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty