Organization
BRIGHTSIDE COWORKING INC
Active
Other names
Luminesce Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN KAY SCHUCHMAN MSW (PRESIDENT)
(503) 754-2636
Entity
Organization
Contact information
Practice address
6018 SE STARK ST STE 103, PORTLAND, OR 97215-1990
(503) 206-5405
Mailing address
624 SE 70TH AVE, PORTLAND, OR 97215-2126
(503) 382-9506
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/11/2021
Last updated
10/27/2021
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