Ethan J Newcomb, PSS - Portland, OR

Ethan J Newcomb, PSS

Peer Specialist in Portland, Oregon

NPI 1699373324

Ethan J Newcomb is a Peer Specialist based in Portland, OR. Ethan J Newcomb practices in Portland, OR and has the professional credentials of PSS. The NPI Number for Ethan J Newcomb is 1699373324 and holds a License No. THW000104645 (Oregon).

The current practice location address for Ethan J Newcomb is 1438 Se Division St, Portland, OR and can be reached out via phone at 503-548-0346 and via fax at 503-232-5959.

Location: 1438 Se Division St, Portland, OR, 97205-1715

NPI Number

1699373324

Provider Name

Ethan J Newcomb

Credential

PSS

Provider Entity Type

Individual

Gender

Male

Address

1438 Se Division St, Portland, OR, 97205-1715

Phone Number

503-548-0346

Fax Number

503-232-5959

Provider Enumeration Date

10/14/2020

Last Update Date

03/10/2024

Identifier	Type	State	Issuer
500795004	05	OR

Address

1438 Se Division St

City

Portland

State

Oregon

Zip

97202-1140

Phone Number

503-548-0346

Fax Number

503-232-5959

Address

1438 Se Division St

City

Portland

State

Oregon

Zip

97202-1140

Phone Number

503-548-0346

Fax Number

503-232-5959

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

THW000104645 (Oregon)

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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