| Mindmap Llc | |
|
4003 Ne Grand Ave Portland OR 97212-1109 | |
| (503) 970-2522 | |
| (503) 387-3253 |
| Full Name | Mindmap Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4003 Ne Grand Ave, Portland, Oregon |
| Authorized Official Name and Position | Joseph Christensen (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 5039702522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindmap Llc 19871 View Dr West Linn OR 97068-1347 Ph: (503) 387-3253 | Mindmap Llc 4003 Ne Grand Ave Portland OR 97212-1109 Ph: (503) 970-2522 |
| NPI Number | 1720491616 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 06/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720491616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 507580 (Virginia) | Secondary |
| 106H00000X | Marriage & Family Therapist | T0555 (Oregon) | Primary |
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