Provider Demographics
NPI:1275338519
Name:RHODA PSYCHIATRY
Entity type:Organization
Organization Name:RHODA PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-406-9062
Mailing Address - Street 1:830 NE HOLLADAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2104
Mailing Address - Country:US
Mailing Address - Phone:503-406-9062
Mailing Address - Fax:503-782-1884
Practice Address - Street 1:830 NE HOLLADAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2104
Practice Address - Country:US
Practice Address - Phone:503-406-9062
Practice Address - Fax:503-782-1884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty