Organization
ILLUMINATE HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINNEA STENHOUSE LCSW (OWNER/MANAGER)
(503) 272-1482
Entity
Organization
Contact information
Practice address
2926 NE FLANDERS ST STE 3A, PORTLAND, OR 97232-3259
(503) 272-1482
Mailing address
3439 SE HAWTHORNE BLVD # 1177, PORTLAND, OR 97214-5048
(503) 272-1482
(503) 427-9765
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500704520
—
OR
Enumeration date
11/17/2023
Last updated
11/17/2023
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