Healthcare Provider Details
I. General information
NPI: 1336054188
Provider Name (Legal Business Name): COLLABORATIVE COMPASSION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3506 SE 66TH AVE STE 202
PORTLAND OR
97206-2626
US
IV. Provider business mailing address
3506 SE 66TH AVE STE 202
PORTLAND OR
97206-2626
US
V. Phone/Fax
- Phone: 503-884-9749
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
DOO
Title or Position: THERAPIST
Credential: MSW
Phone: 503-884-9749