Organization
LIGHT MIND WELLNESS
Active
Other names
Light Mind Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA PERRETTA LMFT (OWNER/PRACTITIONER)
(503) 926-9567
Entity
Organization
Contact information
Practice address
6734 SE RAYMOND ST, PORTLAND, OR 97206-4520
(503) 926-9567
Mailing address
5010 SE FOSTER RD, PORTLAND, OR 97206-3039
(503) 926-9567
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518377167
PERSONAL NPI
—
Enumeration date
01/01/2021
Last updated
02/15/2021
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