Healthcare Provider Details

I. General information

NPI: 1962334052
Provider Name (Legal Business Name): SANTHOSA THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6775 SE BLANTON ST APT 2204
HILLSBORO OR
97129-2100
US

IV. Provider business mailing address

2850 SW CEDAR HILLS BLVD # 2269
BEAVERTON OR
97005-1354
US

V. Phone/Fax

Practice location:
  • Phone: 646-427-7618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RUSHINI K JAYAWARDENA
Title or Position: OWNER, THERAPIST
Credential: LCSW
Phone: 646-427-7618