=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285522839
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEMINE HEALTH AND WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2025
-----------------------------------------------------
Last Update Date | 06/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4145 SW WATSON AVE STE 334
-----------------------------------------------------
City | BEAVERTON
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97005-2132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-389-9962
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4145 SW WATSON AVE STE 334
-----------------------------------------------------
City | BEAVERTON
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97005-2132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-389-9962
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HELEN METTU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 240-389-9962
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------