Organization
CULTIVATING A NEW LIFE LLC
Active
Other names
Cultivating A New Life
Organization subpart
No
Provider details
NPI number
Authorized official
MISS FUMIYO NISHIMOTO LCSW (OWNER)
(541) 904-0468
Entity
Organization
Contact information
Practice address
205 SE SPOKANE ST STE 300, PORTLAND, OR 97202-6487
(541) 904-0468
Mailing address
205 SE SPOKANE ST STE 300, PORTLAND, OR 97202-6487
(541) 904-0468
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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