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Organization

INNER SPACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLEY BURKE LPC (OWNER)
(503) 459-1675
Entity
Organization

Contact information

Practice address
6118 SE BELMONT ST STE 328, PORTLAND, OR 97215-1982
(503) 662-8511
Mailing address
3389 NE 162ND AVE, PORTLAND, OR 97230-5016
(503) 459-1675

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
08/11/2025
Last updated
08/11/2025
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