# LIFE BALANCE NORTHWEST, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Life Balance Northwest
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538477500
- **Authorized official:** ANN MARIE CHILDERS MD (PSYCHIATRIST)
- **Authorized official phone:** (503) 344-6211

## Contact information

- **Practice address:** 1595 HOLLY ST, WEST LINN, OR 97068-3326
- **Practice address phone:** (503) 344-6211
- **Practice address fax:** (503) 344-6991
- **Mailing address:** 333 S STATE ST V137, LAKE OSWEGO, OR 97034-5052
- **Mailing address phone:** (503) 344-6211
- **Mailing address fax:** (503) 344-6991

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | MD19493 | OR | Yes |

## Other

- **Enumeration date:** 09/23/2010
- **Last updated:** 10/17/2016