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General NPI Number Information
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NPI Number | 1538563242
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Entity Type | Organization
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Legal Business Name | LIFEKEY COUNSELING
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 4838 NE SANDY BLVD SUITE 210
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City | PORTLAND
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State | OR
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Zip | 97213-2091
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Country | US
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Telephone | 503-284-6754
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Fax | 503-284-6754
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Provider Business Mailing Address
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Address Line | 4106 NE 42ND ST
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City | VANCOUVER
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State | WA
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Zip | 98661-3121
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Country | US
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Telephone | 503-784-2123
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEREMY MCALLISTER
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Credential |
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Telephone | 503-284-6754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C3882
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License Number State | OR
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