Organization
CHRYSALIS WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJNA RAE (OWNER)
(503) 451-0079
Entity
Organization
Contact information
Practice address
4659 NE AINSWORTH ST, PORTLAND, OR 97218-1849
(503) 451-0079
(503) 486-3527
Mailing address
4659 NE AINSWORTH ST, PORTLAND, OR 97218-1849
(503) 451-0079
(503) 486-3527
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/04/2025
Last updated
09/04/2025
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