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Organization

DYNAMIC THERAPY ALLIANCE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA KINMAN LCSW (LICENSED CLINICAL SOCIAL WORKER)
(970) 258-0220
Entity
Organization

Contact information

Practice address
2404 SE 113TH AVE, PORTLAND, OR 97216-4042
(971) 259-8022
(971) 484-4002
Mailing address
2404 SE 113TH AVE APT A, PORTLAND, OR 97216-4042
(971) 259-8022
(971) 484-4002

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
04/09/2025
Last updated
03/16/2026
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