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Organization
SPROUT THERAPY PDX LLC
Active
Organization
SPROUT THERAPY PDX LLC
Active
Other names
Sprout Therapy PDX
Organization subpart
No
Provider details
NPI number
Authorized official
EMELIE ANGELINA DOUGLAS LPC (CEO)
(503) 209-0914
Entity
Organization
Contact information
Practice address
7704 N HEREFORD AVE, PORTLAND, OR 97203-3434
(971) 319-4827
(503) 662-6220
Mailing address
9133 N ALLEGHENY AVE, PORTLAND, OR 97203-2303
(503) 209-0914
(503) 662-6220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
03/12/2026
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