Organization
WILD OPEN BEING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIMONE LEVINE (OWNER)
(714) 609-0015
Entity
Organization
Contact information
Practice address
7831 SE STARK ST STE 211, PORTLAND, OR 97215-2313
(714) 609-0015
Mailing address
1512 NE HOLMAN ST, PORTLAND, OR 97211-4850
(714) 609-0015
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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