LIGHT SIDE WELLNESS CO.

PORTLAND, OR
NPI1710660956
Entity TypeOrganization
Authorized ContactSTEVEN JON KNOTT
Owner
503-773-4673
Organization Subpart ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date2023-08-14
Last Update Date2023-08-14
Business Address
LIGHT SIDE WELLNESS CO.
2175 NW RALEIGH ST STE 110
PORTLAND, OR 97210-2392
Phone number: 503-773-4673
Mailing Address
LIGHT SIDE WELLNESS CO.
2355 STATE ST STE 101
SALEM, OR 97301-4541
Phone number: 503-773-4673