Provider Demographics
NPI:1215713961
Name:CLINICOPS LLC
Entity type:Organization
Organization Name:CLINICOPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVES
Authorized Official - Suffix:
Authorized Official - Credentials:ND, MBA
Authorized Official - Phone:503-972-0235
Mailing Address - Street 1:2459 SE TUALATIN VALLEY HWY # 416
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-7919
Mailing Address - Country:US
Mailing Address - Phone:503-972-0235
Mailing Address - Fax:
Practice Address - Street 1:1427 NW FLANDERS ST STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2646
Practice Address - Country:US
Practice Address - Phone:503-972-0235
Practice Address - Fax:503-379-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500732051Medicaid