| Waystone Therapy Llc | |
|
2951 Se Taylor St Portland OR 97214-4032 | |
| (503) 453-4807 | |
| (971) 544-7182 |
| Full Name | Waystone Therapy Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 2951 Se Taylor St, Portland, Oregon |
| Authorized Official Name and Position | Courtney Watson (OWNER) |
| Authorized Official Contact | 5034534807 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waystone Therapy Llc Po Box 15142 Portland OR 97293-5142 Ph: (503) 453-4807 | Waystone Therapy Llc 2951 Se Taylor St Portland OR 97214-4032 Ph: (503) 453-4807 |
| NPI Number | 1962158170 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 02/25/2022 |
| Certification Date | 02/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962158170 | NPI | - | NPPES |
| 500802870 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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