Rising Moon Therapy Center Llc | |
4301 Sw Dosch Rd Portland OR 97239-1378 | |
(503) 512-0958 | |
Not Available |
Full Name | Rising Moon Therapy Center Llc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 4301 Sw Dosch Rd, Portland, Oregon |
Authorized Official Name and Position | Alicia Simone (OWNER/LMFT) |
Authorized Official Contact | 5035120958 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Rising Moon Therapy Center Llc 6312 Sw Capitol Hwy # 245 Portland OR 97239-1938 Ph: (503) 512-0958 | Rising Moon Therapy Center Llc 4301 Sw Dosch Rd Portland OR 97239-1378 Ph: (503) 512-0958 |
NPI Number | 1871211151 |
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Provider Enumeration Date | 08/22/2022 |
Last Update Date | 08/22/2022 |
Certification Date | 08/22/2022 |
Identifier | Type | State | Issuer |
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1871211151 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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