| Lifestance Health | |
|
18765 Sw Boones Ferry Rd Ste 100 Tualatin OR 97062-8607 | |
| (503) 612-1000 | |
| Not Available |
| Full Name | Lifestance Health |
|---|---|
| Speciality | Counselor |
| Location | 18765 Sw Boones Ferry Rd Ste 100, Tualatin, Oregon |
| Authorized Official Name and Position | Ryan Pardo (CHIEF LEGAL OFFICER) |
| Authorized Official Contact | 4252798500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifestance Health Po Box 8550 Pasadena CA 91109-8602 Ph: (503) 233-5405 | Lifestance Health 18765 Sw Boones Ferry Rd Ste 100 Tualatin OR 97062-8607 Ph: (503) 612-1000 |
| NPI Number | 1073056826 |
|---|---|
| Provider Enumeration Date | 11/28/2016 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073056826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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