Individual ProviderEmily Catherine PersicoCounselorBehavioral Health & Social Service ProvidersPractice Address11456 NE Knott St, Portland, OR 97220-1706(503) 736-6671(503) 200-7346PECOS EnrollmentBased on the most recent information from CMS, provider Emily Catherine Persico 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 ID1821347535Provider TypeIndividualFull NamePersico, Emily CatherineCredentialMCGenderFemaleSole ProprietorNoEnumeration Date9/10/2012Last Updated5/2/2022Contact InformationPractice LocationPractice Address11456 NE Knott St, Portland, OR 97220-1706Phone(503) 736-6671FaxUnlisted FaxMailing LocationMailing Address15330 SE Yamhill St, Portland, OR 97233-2953Phone(503) 200-7346FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseC6219OregonCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseR3493Oregon