| Wellness Path, Llc | |
|
7805 Sw 40th Ave # 80381 Portland OR 97219-1643 | |
| (503) 482-8561 | |
| Not Available |
| Full Name | Wellness Path, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 7805 Sw 40th Ave # 80381, Portland, Oregon |
| Authorized Official Name and Position | Kristin Elizabeth Hajny (THERAPIST) |
| Authorized Official Contact | 5034828561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Path, Llc 7805 Sw 40th Ave # 80381 Portland OR 97219-1643 Ph: (503) 482-8561 | Wellness Path, Llc 7805 Sw 40th Ave # 80381 Portland OR 97219-1643 Ph: (503) 482-8561 |
| NPI Number | 1588261473 |
|---|---|
| Provider Enumeration Date | 10/05/2020 |
| Last Update Date | 02/20/2023 |
| Certification Date | 02/15/2023 |
| Medicare PECOS PAC ID | 4082027479 |
|---|---|
| Medicare Enrollment ID | O20201231001796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588261473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristin Hajny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598372070 PECOS PAC ID: 5991118382 Enrollment ID: I20210103000001 |
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