Individual provider · Type 1 NPI

Patrick G. Eagle Staff, PWS/QMHP-C

Peer Specialist · Portland, OR

NPI number 1316477441 Active

Practice location

1310 SW 17th Ave
Portland, OR 97201-2522

Call (503) 231-2641 Map

Fax (503) 467-4077

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Other practice locations

  • 620 NE 2nd St, Gresham, OR 97030-7514 · (971) 274-3757
  • 1631 SW Columbia St, Portland, OR 97201-6025 · (503) 621-2235

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X19-QMHPC-00380 (OR)
Peer Specialist Primary 175T00000XTHW0002219 (OR)

Peer Specialist: 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.

32 other providers at this address

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About NPI 1316477441

Patrick G. Eagle Staff, PWS/QMHP-C's National Provider Identifier is 1316477441, issued on Jun 12, 2017. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Portland, OR. The record was last updated on May 24, 2019.