Provider Demographics
NPI:1265735088
Name:PASIMIO, MICHAEL ARTHUR RHYS (LPC, CADC II)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ARTHUR RHYS
Last Name:PASIMIO
Suffix:
Gender:M
Credentials:LPC, CADC II
Other - Prefix:
Other - First Name:RHYS
Other - Middle Name:
Other - Last Name:PASIMIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:123 E POWELL BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7622
Mailing Address - Country:US
Mailing Address - Phone:971-220-6449
Mailing Address - Fax:
Practice Address - Street 1:123 E POWELL BLVD STE 212
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7622
Practice Address - Country:US
Practice Address - Phone:971-220-6449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No372600000XNursing Service Related ProvidersAdult Companion