# POSITIVE INNER SELF, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mind & Body Wellness Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912577305
- **Authorized official:** JENNIFER WILLLIS (OFFICE MANAGER)
- **Authorized official phone:** (503) 461-3910

## Contact information

- **Practice address:** 6700 SW 105TH AVE STE 215, BEAVERTON, OR 97008-8824
- **Practice address phone:** (971) 233-6052
- **Practice address fax:** (971) 277-7291
- **Mailing address:** 6700 SW 105TH AVE STE 215, BEAVERTON, OR 97008-8824
- **Mailing address phone:** (503) 461-3910
- **Mailing address fax:** (971) 277-7291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 171100000X | Acupuncturist | — | NULL | — |
| 171100000X | Acupuncturist | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 175F00000X | Naturopath | — | NULL | — |
| 175F00000X | Naturopath | — | — | — |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/28/2021
- **Last updated:** 12/29/2025