Organization
SAKURA RECOVERY AND WELLNESS, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN RICE NP (PSYCHIATRIC NURSE PRACTITIONER/OWNE)
(310) 701-7242
Entity
Organization
Contact information
Practice address
1675 SW MARLOW AVE STE 315, PORTLAND, OR 97225-5105
(310) 701-7242
Mailing address
1675 SW MARLOW AVE STE 315, PORTLAND, OR 97225-5105
(310) 701-7242
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201403432NP-PP
OR
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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