Healthcare Provider Details

I. General information

NPI: 1417715921
Provider Name (Legal Business Name): HELLSTROM PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2024
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 6TH ST
OREGON CITY OR
97045-1801
US

IV. Provider business mailing address

PO BOX 283
GLADSTONE OR
97027-0283
US

V. Phone/Fax

Practice location:
  • Phone: 503-319-0885
  • Fax: 844-621-8908
Mailing address:
  • Phone: 53-319-0885
  • Fax: 844-621-8908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA HELLSTROM
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 503-913-5629