NW MIND-BODY WELLNESS LLC NPI 1467969220

NPI Information

NPI: 1467969220
Provider Name: NW MIND-BODY WELLNESS, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 38D2210227

Address:
16986 NW LYNCH LN
PORTLAND, OR
ZIP 97229
Phone: (615) 497-1146
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NW MIND-BODY WELLNESS, LLC is a psychiatric/mental health nurse practitioner in Portland, OR. NW MIND-BODY WELLNESS, LLC NPI is 1467969220. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16986 NW LYNCH LN
PORTLAND, OR
ZIP 97229-221
Phone: (615) 497-1146
Fax: (615) 497-1146

The provider's authorized official is Rebecca Dorsey .
The authorized official title is Owner / Provider and has the following contact phone number (503) 707-1950.

The CLIA number assigned to this NPI record is 38D2210227 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/2/2018 and was last updated on 6/11/2019.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201406327NP-PP	OREGON	Yes

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: 4/28/2024

NPI Synchronization or Removal

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