Organization
SPRINGWATER THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RITA COFFIN HILL PSY.D. (MEMBER)
(503) 690-0306
Entity
Organization
Contact information
Practice address
1324 SE SPOKANE ST, PORTLAND, OR 97202-6634
(503) 690-0306
(503) 967-7066
Mailing address
PO BOX 82034, PORTLAND, OR 97282-0034
(503) 690-0306
(503) 967-7066
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1280
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457372096
INDIVIDUAL NPI
OR
Enumeration date
01/26/2012
Last updated
01/26/2012
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