BALANCE FOR HEALTHY LIVING PC NPI 1265740096

NPI Information

NPI: 1265740096
Provider Name: BALANCE FOR HEALTHY LIVING, PC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
4729 NE 50TH PL
PORTLAND, OR
ZIP 97218
Phone: (503) 407-9232
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BALANCE FOR HEALTHY LIVING, PC is a professional counselor in Portland, OR. BALANCE FOR HEALTHY LIVING, PC NPI is 1265740096. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4729 NE 50TH PL
PORTLAND, OR
ZIP 97218-009
Phone: (503) 407-9232
Fax: (503) 328-7081

The provider's authorized official is Tirzah D Jacob .
The authorized official title is Licensed Professional Counselor and has the following contact phone number (503) 407-9232.

The enumeration date for this NPI number is 9/14/2010 and was last updated on 11/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		C1780	OREGON	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	02-11-44	OREGON	No
3	101YM0800X	Counselor	Mental Health	C1780	OREGON	No
4	101YP2500X	Counselor	Professional	C1780	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500601179	MEDICAID	OREGON
2	11607801	OTHER	OREGON	CAQH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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