Provider Demographics
NPI:1275362451
Name:OCEANIC HEALTH GROUP LLC
Entity type:Organization
Organization Name:OCEANIC HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:NYABERO
Authorized Official - Last Name:OBINO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:612-423-3606
Mailing Address - Street 1:1500 NW BETHANY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5236
Mailing Address - Country:US
Mailing Address - Phone:612-423-3606
Mailing Address - Fax:
Practice Address - Street 1:1500 NW BETHANY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5236
Practice Address - Country:US
Practice Address - Phone:612-423-3606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty