| Phoenix Therapies Llc | |
|
7831 Se Stark St Suite 202 Portland OR 97215-2357 | |
| (503) 956-6133 | |
| Not Available |
| Full Name | Phoenix Therapies Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7831 Se Stark St, Portland, Oregon |
| Authorized Official Name and Position | Korel Ponti-foss (PRESIDENT) |
| Authorized Official Contact | 3602590864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Therapies Llc 7831 Se Stark St Suite 202 Portland OR 97215-2357 Ph: () - | Phoenix Therapies Llc 7831 Se Stark St Suite 202 Portland OR 97215-2357 Ph: (503) 956-6133 |
| NPI Number | 1326582412 |
|---|---|
| Provider Enumeration Date | 12/08/2016 |
| Last Update Date | 12/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326582412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | T1102 (Oregon) | Primary |
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