NPI 1104631811

Active Recovery Tms PLLC

Organisation Psychiatry Physician Portland, OR

Practice location

Address: 2701 NW Vaughn St STE 470, Portland, OR 97210-5326
Phone: (206) 210-1198
Fax: (503) 914-1401
Mailing address: 11850 SW 67th Ave, Portland, OR 97223-8961

Authorised official

Name: Amy Dawn Moore
Title: Contractor
Phone: (503) 819-6585

Registered specialties

Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X

Other Psychiatry & Neurology providers in Oregon →

Registry record

NPI: 1104631811
Entity type: Organization
NPI issued: 10 Feb 2025
Record last updated: 10 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.