Provider Demographics
NPI:1922369040
Name:WESTERN SEMINARY
Entity Type:Organization
Organization Name:WESTERN SEMINARY
Other - Org Name:A NEW DAY COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-517-1806
Mailing Address - Street 1:5511 SE HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3367
Mailing Address - Country:US
Mailing Address - Phone:786-263-9329
Mailing Address - Fax:
Practice Address - Street 1:5511 SE HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3367
Practice Address - Country:US
Practice Address - Phone:786-263-9329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN SEMINARY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health