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General NPI Number Information
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NPI Number | 1316895493
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Entity Type | Organization
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Legal Business Name | THE RISE MOOR HEALING CENTER
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 2130 N KILPATRICK ST UNIT 17634
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City | PORTLAND
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State | OR
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Zip | 97217-0025
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Country | US
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Telephone | 509-406-4853
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Fax |
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Provider Business Mailing Address
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Address Line | 2130 N KILPATRICK ST UNIT 17634
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City | PORTLAND
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State | OR
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Zip | 97217-0025
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Country | US
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Telephone | 509-406-4853
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Fax |
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Authorized Official
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Title or Position | MINISTER OF INFORMATION
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Name | SHEIK DURRELL KINSEY BEY
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Credential |
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Telephone | 509-406-4853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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