Provider Demographics
NPI:1932339280
Name:GEORGE DRINKA MD AND BARBARA DRINKA LCSW PC
Entity Type:Organization
Organization Name:GEORGE DRINKA MD AND BARBARA DRINKA LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DRINKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-226-0558
Mailing Address - Street 1:2250 NW FLANDERS ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-0411
Mailing Address - Country:US
Mailing Address - Phone:503-226-0558
Mailing Address - Fax:503-276-1284
Practice Address - Street 1:2250 NW FLANDERS ST
Practice Address - Street 2:SUITE 306
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-0411
Practice Address - Country:US
Practice Address - Phone:503-226-0558
Practice Address - Fax:503-276-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR000665102L00000X, 1041C0700X
102L00000X, 1041C0700X, 2084P0800X
ORMD141892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R167810Medicare PIN