| Illuminate Healing Llc | |
|
2926 Ne Flanders St Ste 3a Portland OR 97232-3259 | |
| (503) 272-1482 | |
| Not Available |
| Full Name | Illuminate Healing Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2926 Ne Flanders St Ste 3a, Portland, Oregon |
| Authorized Official Name and Position | Linnea Stenhouse (OWNER/MANAGER) |
| Authorized Official Contact | 5032721482 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Healing Llc 3439 Se Hawthorne Blvd # 1177 Portland OR 97214-5048 Ph: (503) 272-1482 | Illuminate Healing Llc 2926 Ne Flanders St Ste 3a Portland OR 97232-3259 Ph: (503) 272-1482 |
| NPI Number | 1053186247 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/17/2023 |
| Certification Date | 11/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053186247 | NPI | - | NPPES |
| 500704520 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
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