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Organization

RADIANCE INTEGRATIVE HEALTH & WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUNDAURA LITHMAN LCSW (MANAGER, TREASURER)
(541) 973-3797
Entity
Organization

Contact information

Practice address
8125 SE PINE ST, PORTLAND, OR 97215-1554
(503) 743-8364
Mailing address
1130 SW MORRISON ST STE 328, PORTLAND, OR 97205-2214
(503) 743-8364

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
261QH0100X
Health Service Clinic/Center
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM2500X
Medical Specialty Clinic/Center

Other

Enumeration date
06/29/2024
Last updated
06/29/2024
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