| Inner Domain Holistic Health, Llc | |
|
6700 Sw 105th Ave Ste 211 Beaverton OR 97008-8824 | |
| (503) 974-4624 | |
| Not Available |
| Full Name | Inner Domain Holistic Health, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6700 Sw 105th Ave Ste 211, Beaverton, Oregon |
| Authorized Official Name and Position | Allison Fox (OWNER) |
| Authorized Official Contact | 5038809160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Inner Domain Holistic Health, Llc 2423 Se 49th Ave Portland OR 97206-1561 Ph: (503) 880-9160 | Inner Domain Holistic Health, Llc 6700 Sw 105th Ave Ste 211 Beaverton OR 97008-8824 Ph: (503) 974-4624 |
| NPI Number | 1720965908 |
|---|---|
| Provider Enumeration Date | 08/19/2025 |
| Last Update Date | 08/19/2025 |
| Certification Date | 08/19/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720965908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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