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General NPI Number Information
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NPI Number | 1518470210
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Entity Type | Organization
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Legal Business Name | BOTH-AND COUNSELING
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 224 NE 28TH AVE
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City | PORTLAND
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State | OR
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Zip | 97232
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Country | US
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Telephone | 503-957-2544
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12154
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City | PORTLAND
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State | OR
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Zip | 97212-0154
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Country | US
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Telephone | 408-250-3134
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | HEATHER ASAADI
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Credential | LPC
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Telephone | 503-957-2544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | C4454
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License Number State | OR
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