| Basic Mindfulness Portland, Llc | |
|
1920 Nw Johnson St Suite 103 Portland OR 97209-1325 | |
| (503) 719-5499 | |
| Not Available |
| Full Name | Basic Mindfulness Portland, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1920 Nw Johnson St, Portland, Oregon |
| Authorized Official Name and Position | Janet M. Sims (CO-OWNER) |
| Authorized Official Contact | 5037195499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basic Mindfulness Portland, Llc 1920 Nw Johnson St Suite 103 Portland OR 97209-1325 Ph: (503) 719-5499 | Basic Mindfulness Portland, Llc 1920 Nw Johnson St Suite 103 Portland OR 97209-1325 Ph: (503) 719-5499 |
| NPI Number | 1902128804 |
|---|---|
| Provider Enumeration Date | 02/18/2010 |
| Last Update Date | 02/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902128804 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1978 (Oregon) | Primary |
| 1041C0700X | Social Worker - Clinical | 4220 (Oregon) | Secondary |
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