Organization
SPARK BEHAVIORAL HEALTH LLC
Active
Other names
Spark Behavioral Health LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TIMNIT YIKEALO (CO-CEO)
(971) 228-9848
Entity
Organization
Contact information
Practice address
11000 SW BARBUR BLVD STE 100, PORTLAND, OR 97219-8691
(971) 228-9848
Mailing address
4550 SW BETTS AVE # 44, BEAVERTON, OR 97005-2869
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
08/05/2025
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