Healthcare Provider Details
I. General information
NPI: 1821925785
Provider Name (Legal Business Name): YOUR STORY MATTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3701 SE MILWAUKIE AVE STE G
PORTLAND OR
97202-3835
US
IV. Provider business mailing address
3701 SE MILWAUKIE AVE STE G
PORTLAND OR
97202-3835
US
V. Phone/Fax
- Phone: 503-893-9084
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JUNYEON
PAUL
KIM
Title or Position: OWNER
Credential: LCSW
Phone: 503-893-9084