Provider Demographics
NPI:1124898853
Name:PONEC, STEVEN JAMES
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:PONEC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7010 NE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4081
Mailing Address - Country:US
Mailing Address - Phone:503-708-3390
Mailing Address - Fax:
Practice Address - Street 1:780 COMMERCIAL ST SE STE 104
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3465
Practice Address - Country:US
Practice Address - Phone:971-901-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health