| Prisma Wellness Llc | |
|
3705 Se Cesar Chavez Blvd Portland OR 97202-1704 | |
| (206) 785-1015 | |
| (206) 785-1023 |
| Full Name | Prisma Wellness Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 3705 Se Cesar Chavez Blvd, Portland, Oregon |
| Authorized Official Name and Position | Scott Wiener (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 2067851015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prisma Wellness Llc 321 Burnett Ave S Fl 2 Renton WA 98057-2558 Ph: (206) 785-1015 | Prisma Wellness Llc 3705 Se Cesar Chavez Blvd Portland OR 97202-1704 Ph: (206) 785-1015 |
| NPI Number | 1154942142 |
|---|---|
| Provider Enumeration Date | 04/30/2020 |
| Last Update Date | 10/10/2024 |
| Certification Date | 10/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154942142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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