MINDFUL THERAPY PACIFIC NW LLC NPI 1437810538

NPI Information

NPI: 1437810538
Provider Name: MINDFUL THERAPY PACIFIC NW, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2245 SW TROY ST
PORTLAND, OR
ZIP 97219
Phone: (503) 341-6393
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MINDFUL THERAPY PACIFIC NW, LLC is a mental health counselor in Portland, OR. MINDFUL THERAPY PACIFIC NW, LLC NPI is 1437810538. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2245 SW TROY ST
PORTLAND, OR
ZIP 97219-657
Phone: (503) 341-6393
Fax: (888) 920-2077

The provider's authorized official is Jennifer Samsom .
The authorized official title is Director and has the following contact phone number (503) 341-6393.

The enumeration date for this NPI number is 1/1/2022 and was last updated on 1/1/2022.

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	101YM0800X	Counselor	Mental Health			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	1003129115	MEDICAID	OREGON

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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