institution
Light Side Wellness Co.
Psychiatric/Mental Health Nurse Practitioner in Portland, Oregon
NPI 1710660956

Light Side Wellness Co. is a Psychiatric/Mental Health Nurse Practitioner based in Salem, OR and is specialized in Psychiatric/Mental Health. Light Side Wellness Co. practices in Portland, OR. The NPI Number for Light Side Wellness Co. is 1710660956 and holds a License No. (Oregon).

The current practice location address for Light Side Wellness Co. is 2175 Nw Raleigh St Ste 110, Portland, OR and can be reached out via phone at 503-773-4673.

Location: 2175 Nw Raleigh St Ste 110, Portland, OR, 97301-4541
institution
Provider Profile Details
NPI Number
1710660956
Provider Name
Light Side Wellness Co.
Credential
Provider Entity Type
Organization
Address
2175 Nw Raleigh St Ste 110, Portland, OR, 97301-4541
Phone Number
503-773-4673
Fax Number
Provider Enumeration Date
08/14/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
2175 Nw Raleigh St Ste 110
City
State
Zip
97210-2392
Phone Number
503-773-4673
Fax Number
person
Provider Business Mailing Address Details
Address
2175 Nw Raleigh St Ste 110
City
State
Zip
97210-2392
Phone Number
503-773-4673
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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