# LILAC WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lilac Wellness and Counseling
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104322841
- **Authorized official:** PAM CONNELL (ADMINISTRATION)
- **Authorized official phone:** (503) 587-9937

## Contact information

- **Practice address:** 2651 COMMERCIAL ST SE STE 1, SALEM, OR 97302-4872
- **Practice address phone:** (503) 587-9937
- **Practice address fax:** (503) 994-8049
- **Mailing address:** 2651 COMMERCIAL ST SE STE 1, SALEM, OR 97302-4872
- **Mailing address phone:** (503) 587-9937
- **Mailing address fax:** (503) 994-8049

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/02/2018
- **Last updated:** 12/13/2019