Organization
BRAIDED RIVER COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD MERCURAL LPC (OWNER)
(503) 389-0550
Entity
Organization
Contact information
Practice address
2545 NE 25TH AVE, PORTLAND, OR 97212-4839
(503) 389-0550
Mailing address
2545 NE 25TH AVE, PORTLAND, OR 97212-4839
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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