Brave Space, LLC
Brave Space, LLC is a Community/Behavioral Health Agency in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2016.
- Licensed in
- OR
- In the registry since
- 2016
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
3620 SE Powell Blvd # 102Portland, OR 97202-1880
Phone: (503) 486-8936
Fax: (503) 894-6020
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence C3371 (OR) |
|---|
Record details
| NPI number | 1255885919 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Full Spectrum Therapy LLC |
| Authorized official | Sam Skye — Ceo · (503) 765-5584 |
| NPI enumerated | August 11, 2016 |
| Last updated in NPPES | May 18, 2023 |
| Certification date | May 18, 2023 |
| Mailing address | 3620 Se Powell Blvd # 102, Portland, OR 97202-1880 |
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