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General NPI Number Information
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NPI Number | 1629989462
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Entity Type | Organization
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Legal Business Name | LENSA CORPORATION
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Dates
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Enumeration Date | 09/12/2026
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Last Update Date | 09/12/2026
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Provider Practice Location Address
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Address Line | 13250 NE SHAVER ST
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City | PORTLAND
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State | OR
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Zip | 97230-1453
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Country | US
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Telephone | 971-230-8488
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Fax | 971-888-5174
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Provider Business Mailing Address
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Address Line | 13250 NE SHAVER ST
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City | PORTLAND
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State | OR
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Zip | 97230-1453
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BERHANU KEBEDE BEDASSA
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Credential | PMHNP
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Telephone | 213-249-6973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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