Autumn Mist Lovell | Portland, OR • PECOS Search

Autumn Mist Lovell

Social Worker

Behavioral Health & Social Service Providers

3415 SE Powell Blvd, Portland, OR 97202-3371

(503) 234-9591 (541) 852-5567

PECOS Enrollment

Based on the most recent information from CMS, provider Autumn Mist Lovell does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1154671162
Provider Type
Individual
Full Name
Lovell, Autumn Mist
Credential
B.S.

Gender
Female
Sole Proprietor
No
Enumeration Date
9/17/2012
Last Updated
9/17/2012

Contact Information

Practice Location

3415 SE Powell Blvd, Portland, OR 97202-3371

Unlisted Fax

Mailing Location

26180 Alpine Rd, Monroe, OR 97456-9747

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer