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NPI Code Detail

MEDICARE: DASIA STAR THERAPY, LLC

MEDICARE: DASIA STAR THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1144189879
Entity Type Code : Organization
Provider Name (Legal Business Name) : DASIA STAR THERAPY, LLC
Provider Business Mailing Address
First Line : 2225 NE MARTIN LUTHER KING JR BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-3727
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2225 NE MARTIN LUTHER KING JR BLVD
Second Line :
City : PORTLAND
State : OR
Zip : 97212-3727
Country : US
Telephone Number : 503-974-0120
Fax Number :
Authorized Official
Title or Position : MARRIAGE AND FAMILY THERAPIST
Name : DASIA STAR
Credential : LMFT
Telephone Number : 323-899-0680
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “DASIA STAR THERAPY, LLC ” Practice Location

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