Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

The Golden Room LLC

Organization Specialist · NPI 1205172913

The Golden Room LLC is a Specialist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2012.

Licensed in
OR
In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

636 SE 49th Ave
Portland, OR 97215-1728
Phone: (971) 506-4560
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 8161 (OR)

Record details

NPI number1205172913
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mauri McKitrick — Owner/Lmt · (971) 506-4560
NPI enumeratedDecember 27, 2012
Last updated in NPPESDecember 27, 2012
Mailing address4360 Ne Simpson St, Portland, OR 97218-1444

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