Cognitive Care Medical Group

LBN: Cognitive Care Medical Group Llc
Cognitive Care Medical Group is an health care organization with primary practice located at 12901 Se 97Th Ave Ste 105 , Clackamas OR 97015-7902. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Forensic Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. Cognitive Care Medical Group Llc can be contacted via phone (503) 912-4788, or through Wight, Eric George via phone (503) 912-4790.

Contact Information

Primary practice address
12901 Se 97Th Ave Ste 105 Clackamas OR 97015-7902
Phone: (503) 912-4788
Fax: (503) 912-4787
Website:
Map and Directions
Authorized official contact:
Name: Wight, Eric George
Phone: (503) 912-4790

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X
Allopathic & Osteopathic Physicians / Forensic Psychiatry 2084F0202X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1770023186
LBN Legal business name Cognitive Care Medical Group Llc
DBA Doing business as Cognitive Care Medical Group
Authorized official Wight, Eric George
Entity Organization
Organization subpart 1 No
Enumeration date Mar 3rd, 2017
Last updated Sep 12th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1770023186 NPPES
Oregon MEDICAID 500723541

Popular Providers