Healthcare Provider Details

I. General information

NPI: 1144162934
Provider Name (Legal Business Name): CLEAR HEART, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 SE LAKE RD STE 27
PORTLAND OR
97267-2195
US

IV. Provider business mailing address

6901 SE LAKE RD STE 27
PORTLAND OR
97267-2195
US

V. Phone/Fax

Practice location:
  • Phone: 971-266-1693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: STUART MALKIN
Title or Position: OWNER
Credential: LPC
Phone: 971-266-1693