| Trauma Healing Nw, Llc | |
|
4800 Meadows Rd Ste 300 Lake Oswego OR 97035-5277 | |
| (971) 201-1720 | |
| Not Available |
| Full Name | Trauma Healing Nw, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4800 Meadows Rd Ste 300, Lake Oswego, Oregon |
| Authorized Official Name and Position | Lynae Nelson (MEMBER) |
| Authorized Official Contact | 9712011720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma Healing Nw, Llc 4800 Meadows Rd Ste 300 Lake Oswego OR 97035-5277 Ph: (971) 201-1720 | Trauma Healing Nw, Llc 4800 Meadows Rd Ste 300 Lake Oswego OR 97035-5277 Ph: (971) 201-1720 |
| NPI Number | 1669088050 |
|---|---|
| Provider Enumeration Date | 09/21/2020 |
| Last Update Date | 09/21/2020 |
| Certification Date | 09/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669088050 | NPI | - | NPPES |
| C4674 | Other | OR | OBLPCT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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