Organization
CHRISTINELUVELLA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE WATSON LCSW (OWNER)
(971) 415-8733
Entity
Organization
Contact information
Practice address
11885 SW 5TH ST, BEAVERTON, OR 97005-2959
(971) 415-8733
Mailing address
11885 SW 5TH ST, BEAVERTON, OR 97005-2959
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/30/2022
Last updated
04/30/2022
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