is a Mental Health in Portland, Oregon. practices all healthcare services and medical treatments related to Mental Health. The NPI Number for is 1760649511. The last update date is .
's current location address is 1438 Se Division St, Portland, Oregon. You can contact this provider via phone number 5035480346 and fax number 5032325959. The mailing address for is 1438 Se Division St, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1438 Se Division St, Portland, Oregon |
| Phone Number | 5035480346 |
| Fax Number | 5032325959 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1760649511 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1438 Se Division St |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972021140 |
| Phone Number | 5035480346 |
| Fax Number | 5032325959 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
| Licence No | 19-QMHPC-003 |
|
Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500728499 | OR | -- |
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