Organization
THRIVE WEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH C GENTZKOW LPC (EXECUTIVE DIRECTOR)
(971) 248-2651
Entity
Organization
Contact information
Practice address
4949 S MACADAM AVE # 96, PORTLAND, OR 97239-3912
(971) 248-2651
Mailing address
3841 MAPLETON DR, WEST LINN, OR 97068-2123
(971) 248-2651
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4394
1417493719
OR
Enumeration date
03/06/2020
Last updated
08/27/2024
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