Healthcare Provider Details

I. General information

NPI: 1265281000
Provider Name (Legal Business Name): I AM WELL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2024
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 SW GRIFFITH DR STE 239
BEAVERTON OR
97005-4649
US

IV. Provider business mailing address

1110 SE ALDER ST. STE 301 MB #122
PORTLAND OR
97214-2400
US

V. Phone/Fax

Practice location:
  • Phone: 909-285-4950
  • Fax: 909-285-0564
Mailing address:
  • Phone: 909-285-4950
  • Fax: 909-285-0564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLE MARIE FALK
Title or Position: OWNER
Credential: LMFT
Phone: 909-285-4950