Organization
PURE SELF COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA CANO LPC (OWNER)
(503) 908-2530
Entity
Organization
Contact information
Practice address
1020 SW TAYLOR ST STE 500, PORTLAND, OR 97205-2574
(503) 908-2530
Mailing address
1020 SW TAYLOR ST STE 500, PORTLAND, OR 97205-2574
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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