Organization
ANKH WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH K CROWNER CRM, PWS, CT (EXECUTIVE DIRECTOR)
(971) 216-9732
Entity
Organization
Contact information
Practice address
5257 NE MARTIN LUTHER KING JR BLVD STE 202D, PORTLAND, OR 97211-3283
(971) 216-9732
Mailing address
8428 N BLISS ST, PORTLAND, OR 97203-1177
(971) 207-5652
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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