| Vivify Therapeutics, Llc | |
|
315 Ne Evans St Ste 3 Mcminnville OR 97128-4627 | |
| (971) 237-7390 | |
| Not Available |
| Full Name | Vivify Therapeutics, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 315 Ne Evans St Ste 3, Mcminnville, Oregon |
| Authorized Official Name and Position | Cassandra Gardner (OWNER) |
| Authorized Official Contact | 9712377390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivify Therapeutics, Llc 221 Nw 10th St Mcminnville OR 97128-5015 Ph: (971) 237-7390 | Vivify Therapeutics, Llc 315 Ne Evans St Ste 3 Mcminnville OR 97128-4627 Ph: (971) 237-7390 |
| NPI Number | 1225785611 |
|---|---|
| Provider Enumeration Date | 03/04/2022 |
| Last Update Date | 03/04/2022 |
| Certification Date | 03/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225785611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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