| Mindful Health Northwest Llc | |
|
811 E Burnside St Ste 217 Portland OR 97214-1231 | |
| (503) 476-1189 | |
| (866) 650-8756 |
| Full Name | Mindful Health Northwest Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 811 E Burnside St Ste 217, Portland, Oregon |
| Authorized Official Name and Position | Scott Christensen (MEMBER) |
| Authorized Official Contact | 5034761189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Health Northwest Llc 811 E Burnside St Ste 217 Portland OR 97214-1231 Ph: (503) 476-1189 | Mindful Health Northwest Llc 811 E Burnside St Ste 217 Portland OR 97214-1231 Ph: (503) 476-1189 |
| NPI Number | 1144993015 |
|---|---|
| Provider Enumeration Date | 07/27/2021 |
| Last Update Date | 09/17/2021 |
| Certification Date | 09/17/2021 |
| Medicare PECOS PAC ID | 0648668111 |
|---|---|
| Medicare Enrollment ID | O20211102003287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144993015 | NPI | - | NPPES |
| MD192693 | Other | OR | OREGON STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Scott R Christensen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871025197 PECOS PAC ID: 3375816929 Enrollment ID: I20211021003140 |
| Provider Name | Anushka Shenoy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689008682 PECOS PAC ID: 3678845674 Enrollment ID: I20211115002798 |
| Provider Name | Jared Worthington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407248131 PECOS PAC ID: 7810261864 Enrollment ID: I20211217000892 |
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