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Organization
THE GREAT ESCAPE INTUITIVE THERAPIES, LLC
Active
Organization
THE GREAT ESCAPE INTUITIVE THERAPIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL GREATHOUSE LMT, LPC-INTERN (OWNER/ OPERATOR)
(503) 944-9291
Entity
Organization
Contact information
Practice address
1308 NW 20TH AVE, SUITE 4, PORTLAND, OR 97209-1607
(503) 944-9291
(630) 934-9391
Mailing address
1308 NW 20TH AVE, SUITE 4, PORTLAND, OR 97209-1607
(503) 944-9291
(630) 934-9391
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
225700000X
Massage Therapist
Primary
11951
OR
Other
Enumeration date
12/04/2012
Last updated
04/26/2016
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