Organization
BROADER PATH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW LOVETT TALLMAN LCSW (OWNER/THERAPIST)
(503) 753-0243
Entity
Organization
Contact information
Practice address
6904 N KNOWLES AVE, PORTLAND, OR 97217-5117
(503) 753-0243
Mailing address
5441 S MACADAM AVE STE R, PORTLAND, OR 97239-3822
(971) 445-4844
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/08/2026
Last updated
07/20/2026
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