| Braided River Counseling Llc | |
|
2545 Ne 25th Ave Portland OR 97212-4839 | |
| (503) 389-0550 | |
| Not Available |
| Full Name | Braided River Counseling Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2545 Ne 25th Ave, Portland, Oregon |
| Authorized Official Name and Position | Todd Mercural (OWNER) |
| Authorized Official Contact | 5033890550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Braided River Counseling Llc 2545 Ne 25th Ave Portland OR 97212-4839 Ph: () - | Braided River Counseling Llc 2545 Ne 25th Ave Portland OR 97212-4839 Ph: (503) 389-0550 |
| NPI Number | 1326806035 |
|---|---|
| Provider Enumeration Date | 03/07/2024 |
| Last Update Date | 03/07/2024 |
| Certification Date | 03/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326806035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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