| Mindful Growth And Wellness Llc | |
|
4824 Ne 42nd Ave # 177 Portland OR 97218-1661 | |
| (503) 758-9588 | |
| Not Available |
| Full Name | Mindful Growth And Wellness Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4824 Ne 42nd Ave # 177, Portland, Oregon |
| Authorized Official Name and Position | Emily Tess Demarco (MANAGING MEMBER) |
| Authorized Official Contact | 5037589588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Growth And Wellness Llc 4824 Ne 42nd Ave # 177 Portland OR 97218-1661 Ph: () - | Mindful Growth And Wellness Llc 4824 Ne 42nd Ave # 177 Portland OR 97218-1661 Ph: (503) 758-9588 |
| NPI Number | 1346856200 |
|---|---|
| Provider Enumeration Date | 09/16/2020 |
| Last Update Date | 09/16/2020 |
| Certification Date | 09/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346856200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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