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Organization

UNDERDOG ALCHEMY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISHA HARDISON LOVE RN MSN, PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(971) 486-6182
Entity
Organization

Contact information

Practice address
22400 SE STARK ST, GRESHAM, OR 97030-2600
(971) 486-6182
(971) 293-4016
Mailing address
22400 SE STARK ST STE 104, GRESHAM, OR 97030-2618
(971) 486-6182
(971) 293-4016

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
01/12/2026
Last updated
01/12/2026
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