SPARK BEHAVIORAL HEALTH LLC NPI 1376359695

NPI Information

  • NPI: 1376359695
  • Provider Name: SPARK BEHAVIORAL HEALTH LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • :
  • Address: 11000 SW BARBUR BLVD STE 100
    PORTLAND, OR
    ZIP 97219
  • Phone: (971) 228-9848

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NPI Details

SPARK BEHAVIORAL HEALTH LLC is a clinic center in Portland, OR. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SPARK BEHAVIORAL HEALTH LLC NPI is 1376359695. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

11000 SW BARBUR BLVD STE 100
PORTLAND, OR
ZIP 97219-691
Phone: (971) 228-9848

The provider's authorized official is Timnit Yikealo .
The authorized official title is Co-ceo and has the following contact phone number (971) 228-9848.

The enumeration date for this NPI number is 12/10/2024 and was last updated on 8/5/2025.

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
1261Q00000XClinic/CenterYes

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: 11/21/2025

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