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Daniel Chafe Thornbury

Social Worker

Behavioral Health & Social Service Providers

3415 SE Powell Blvd, Parry Center/Waverly, Portland, OR 97202

PECOS Enrollment

This provider is enrolled in PECOS as DANIEL THORNBURY.

Based on the most recent information from CMS, provider Daniel Chafe Thornbury is legally eligible to order and refer claims for Part B and DME services only.

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

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

Profile Details

Provider ID
1780024794
Provider Type
Individual
Full Name
Thornbury, Daniel Chafe
Title
Mr.

Gender
Male
Sole Proprietor
No
Enumeration Date
7/5/2013
Last Updated
7/5/2013

Contact Information

Practice Location

3415 SE Powell Blvd, Parry Center/Waverly, Portland, OR 97202

(503) 234-9591

Unlisted Fax

Mailing Location

3415 SE Powell Blvd, Portland, OR 97202-3371

(503) 234-9591

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 30971235 North Carolina

Daniel Chafe Thornbury

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Mcculloch, Phoenix

Micek, Sydney Keen

Geiger, Morgan Elizabeth

Distor, Alyssa J

Cooper, Samuel T

Barlow, Elise Duverney

Mehigan, Kelly Rose

Gosney, Michael Lee

Little, Bonni Elizabeth

Mccabe, Hannah