| Brave Souls | |
|
6135 Sw Cherryhill Dr Beaverton OR 97008-4446 | |
| (541) 295-5185 | |
| Not Available |
| Full Name | Brave Souls |
|---|---|
| Speciality | Counselor |
| Location | 6135 Sw Cherryhill Dr, Beaverton, Oregon |
| Authorized Official Name and Position | Mary Elizabeth Mcabee (DIRECTOR OF BRAVE SOULS) |
| Authorized Official Contact | 5412955185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brave Souls 6135 Sw Cherryhill Dr Beaverton OR 97008-4446 Ph: (541) 295-5185 | Brave Souls 6135 Sw Cherryhill Dr Beaverton OR 97008-4446 Ph: (541) 295-5185 |
| NPI Number | 1366231037 |
|---|---|
| Provider Enumeration Date | 05/01/2025 |
| Last Update Date | 05/01/2025 |
| Certification Date | 05/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366231037 | NPI | - | NPPES |
| 1871105684 | Medicaid | OR | |
| 1740843689 | Medicaid | OR | |
| 1982431110 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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