| Trajectory Therapy Services, Llc | |
|
2355 State St Ste 101 Salem OR 97301-4541 | |
| (971) 415-5755 | |
| (971) 415-5855 |
| Full Name | Trajectory Therapy Services, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2355 State St Ste 101, Salem, Oregon |
| Authorized Official Name and Position | Dakota Lake (THERAPIST/OWNER) |
| Authorized Official Contact | 6168216584 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trajectory Therapy Services, Llc 5881 N Montana Ave Apt 303 Portland OR 97217-4681 Ph: (616) 821-6584 | Trajectory Therapy Services, Llc 2355 State St Ste 101 Salem OR 97301-4541 Ph: (971) 415-5755 |
| NPI Number | 1356113245 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 10/26/2023 |
| Certification Date | 10/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356113245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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