Organization
HEALINGLIFE SKILLS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA OWEN PMHNP (PRESIDENT)
(503) 788-7726
Entity
Organization
Contact information
Practice address
1924 NE COUCH ST, PORTLAND, OR 97232-3023
(503) 788-7726
Mailing address
PO BOX 820134, PORTLAND, OR 97282-1134
(503) 788-7726
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
092007075N6
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000565
—
OR
Enumeration date
11/20/2008
Last updated
11/20/2008
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