Provider Demographics
NPI:1417087453
Name:PURSLEY, JOSHUAH CAINE (MED)
Entity type:Individual
Prefix:
First Name:JOSHUAH
Middle Name:CAINE
Last Name:PURSLEY
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18936 NE COUCH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-7824
Mailing Address - Country:US
Mailing Address - Phone:503-827-3035
Mailing Address - Fax:
Practice Address - Street 1:521 SW 11TH AVE
Practice Address - Street 2:STE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2634
Practice Address - Country:US
Practice Address - Phone:503-827-3035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health