Provider Demographics
NPI:1538889746
Name:HOLISTIC MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:HOLISTIC MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMARA
Authorized Official - Middle Name:LOREN
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-897-9711
Mailing Address - Street 1:6110 N LOMBARD ST STE B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-4122
Mailing Address - Country:US
Mailing Address - Phone:503-897-9711
Mailing Address - Fax:503-854-0194
Practice Address - Street 1:6110 N LOMBARD ST STE B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-4122
Practice Address - Country:US
Practice Address - Phone:503-897-9711
Practice Address - Fax:503-854-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty