Organization
LAUREN DEISENROTH PMHNP-BC LLC
Active
Other names
Lauren Deisenroth PMHNP-BC
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN KATHERINE DEISENROTH PMHNP-BC (PMHNP, OWNER)
(918) 520-3000
Entity
Organization
Contact information
Practice address
4511 SE HAWTHORNE BLVD, SUITE 215, PORTLAND, OR 97215-3170
(503) 224-6446
Mailing address
4511 SE HAWTHORNE BLVD, SUITE 215, PORTLAND, OR 97215-3170
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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