Provider Demographics
NPI:1790578243
Name:PRICE, PAUL B (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:B
Last Name:PRICE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SE MLK JR BLVD UNIT 105
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2595
Mailing Address - Country:US
Mailing Address - Phone:503-664-9451
Mailing Address - Fax:503-386-3230
Practice Address - Street 1:2219 RIMLAND DR STE 346
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8660
Practice Address - Country:US
Practice Address - Phone:503-664-9451
Practice Address - Fax:503-386-3230
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV831294363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health