Organization
STILLMIND LLC
Active
Other names
STILLMIND LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA PETERSON PMHNP (OWNER)
(971) 350-6955
Entity
Organization
Contact information
Practice address
5441 S MACADAM AVE STE R, PORTLAND, OR 97239-3822
(971) 350-6955
Mailing address
10807 CAPELLA CREEK WAY, RICHMOND, TX 77406-3457
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R275052
MEDICARE
OR
Enumeration date
07/07/2025
Last updated
04/21/2026
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