Organization
A HEALING INTENTION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN C MIYASATO LCSW (OWNER)
(503) 906-7870
Entity
Organization
Contact information
Practice address
12725 SW MILLIKAN WAY, SUITE 300, BEAVERTON, OR 97005-1678
(503) 906-7870
(503) 906-7871
Mailing address
12725 SW MILLIKAN WAY, SUITE 300, BEAVERTON, OR 97005-1678
(503) 906-7870
(503) 906-7871
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5855
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500670052
—
OR
Enumeration date
05/02/2014
Last updated
06/06/2014
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