| In Between Therapy Collective Llc | |
|
3726 Se Lafayette Ct Portland OR 97202-1874 | |
| (207) 504-6405 | |
| Not Available |
| Full Name | In Between Therapy Collective Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3726 Se Lafayette Ct, Portland, Oregon |
| Authorized Official Name and Position | David Adams (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2075046405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| In Between Therapy Collective Llc Po Box 15240 Portland OR 97293-5240 Ph: () - | In Between Therapy Collective Llc 3726 Se Lafayette Ct Portland OR 97202-1874 Ph: (207) 504-6405 |
| NPI Number | 1245939628 |
|---|---|
| Provider Enumeration Date | 02/24/2023 |
| Last Update Date | 02/24/2023 |
| Certification Date | 02/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245939628 | NPI | - | NPPES |
| 500796881 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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