Healthcare Provider Details

I. General information

NPI: 1699251371
Provider Name (Legal Business Name): LENA RICHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 SE LAFAYETTE ST STE 100
PORTLAND OR
97202-3802
US

IV. Provider business mailing address

1219 SE LAFAYETTE ST
PORTLAND OR
97202-3802
US

V. Phone/Fax

Practice location:
  • Phone: 503-765-5733
  • Fax: 971-244-8583
Mailing address:
  • Phone: 503-776-0204
  • Fax: 971-244-8583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: