| Connective Therapy Collective | |
|
4531 Se Belmont St Ste 117 Portland OR 97215-1675 | |
| (414) 550-0257 | |
| Not Available |
| Full Name | Connective Therapy Collective |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4531 Se Belmont St Ste 117, Portland, Oregon |
| Authorized Official Name and Position | Angela Gunn (CEO) |
| Authorized Official Contact | 9713618303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connective Therapy Collective 5510 N Commercial Ave Portland OR 97217-2340 Ph: (971) 361-8303 | Connective Therapy Collective 4531 Se Belmont St Ste 117 Portland OR 97215-1675 Ph: (414) 550-0257 |
| NPI Number | 1114561735 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 02/01/2021 |
| Certification Date | 02/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114561735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
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