Organization
AWAKENED HEART PDX, LLC
Active
Parent organization
AWAKENED HEART PDX, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AWAKENED HEART PDX, LLC
Authorized official
ANN MARIE MCHENRY LMFT (OWNER, MARRIAGE & FAMILY THERAPIST)
(971) 407-3930
Entity
Organization
Contact information
Practice address
1306 NW HOYT ST STE 407, PORTLAND, OR 97209-2787
(971) 407-3930
Mailing address
1306 NW HOYT ST STE 407, PORTLAND, OR 97209-2787
(971) 407-3930
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
T1051
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134628571
NPI TYPE 1
OR
01
—
1477854750
NPI TYPE 1
—
01
—
1609295682
NPI
—
Enumeration date
08/25/2017
Last updated
03/11/2022
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