Individual ProviderAdam HartlaubCounselorBehavioral Health & Social Service ProvidersPractice Address10638 NE Glisan St, Portland, OR 97220-4045(503) 254-6804(503) 645-3581PECOS EnrollmentBased on the most recent information from CMS, provider Adam Hartlaub does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1770849028Provider TypeIndividualFull NameHartlaub, AdamGenderMaleSole ProprietorNoEnumeration Date4/11/2012Last Updated4/11/2012Contact InformationPractice LocationPractice Address10638 NE Glisan St, Portland, OR 97220-4045Phone(503) 254-6804FaxUnlisted FaxMailing LocationMailing Address14600 NW Cornell Rd, Portland, OR 97229-5442Phone(503) 645-3581FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer