Healthcare Provider Details

I. General information

NPI: 1639634009
Provider Name (Legal Business Name): RAINFLOWER PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2019
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 CENTER ST STE 204
OREGON CITY OR
97045-2211
US

IV. Provider business mailing address

419 CENTER ST STE 204
OREGON CITY OR
97045-2211
US

V. Phone/Fax

Practice location:
  • Phone: 503-593-2848
  • Fax: 949-404-6882
Mailing address:
  • Phone: 503-593-2848
  • Fax: 949-404-6882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DANA M JONES
Title or Position: OWNER, PROVIDER
Credential: PMHNP
Phone: 503-593-2848