Light Side Wellness Co
Light Side Wellness Co is a Psychiatric/Mental Health Nurse Practitioner in Portland, Oregon. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
2175 NW Raleigh St Ste 110Portland, OR 97210-2392
Phone: (503) 773-4673
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric/Mental Health Nurse Practitioner (primary) | Taxonomy 363LP0808X |
|---|
Record details
| NPI number | 1710660956 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Steven Knott — Owner · (503) 773-4673 |
| NPI enumerated | August 14, 2023 |
| Last updated in NPPES | August 14, 2023 |
| Certification date | August 12, 2023 |
| Mailing address | 2355 State St Ste 101, Salem, OR 97301-4541 |
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