MEDICARE: VOLITION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1821537499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOLITION, LLC

Provider Business Mailing Address
First Line	:	10350 N VANCOUVER WAY # 65976
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-7530
Country	:	US
Telephone Number	:	503-606-6412
Fax Number	:

Provider Business Practice Location Address
First Line	:	1336 NW FLANDERS ST STE 253
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97209-2645
Country	:	US
Telephone Number	:	503-606-6412
Fax Number	:

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	PHILIP KOLBA
Credential	:	MA LPC LCPC NCC
Telephone Number	:	503-987-0337

Provider Enumeration Date	:	02/16/2017
Last Update Date	:	05/02/2025

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Directions to “VOLITION, LLC ” Practice Location

Language	Start Address	Practice Location

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