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Organization
KARTINI INTENSIVE OUTPATIENT PROGRAM
Active
Organization
KARTINI INTENSIVE OUTPATIENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE NEMIROW ESQ. (DIRECTOR)
(503) 249-8851
Entity
Organization
Contact information
Practice address
2800 N. VANCOUVER AVE, SUITE 118, PORTLAND, OR 97227-1634
(503) 249-8851
(503) 282-3409
Mailing address
2800 N. VANCOUVER AVE, SUITE 118, PORTLAND, OR 97227-1634
(503) 249-8851
(503) 282-3409
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
NON-NUMBERED CERTIFI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26624890
DOMESTIC LLC
OR
01
—
NON-NUMBERED CERTIFI
NON-INPATIENT MH FACILITY
OR
Enumeration date
10/31/2006
Last updated
08/22/2020
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