Provider Demographics
NPI:1861154940
Name:MENDWELL HEALTH LLC
Entity type:Organization
Organization Name:MENDWELL HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER & CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:904-654-7420
Mailing Address - Street 1:11850 SW 67TH AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8961
Mailing Address - Country:US
Mailing Address - Phone:904-654-7420
Mailing Address - Fax:
Practice Address - Street 1:11850 SW 67TH AVE STE 145
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8961
Practice Address - Country:US
Practice Address - Phone:971-204-8598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-06
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty