Organization
CENTER FOR BRAIN-WISE LIVING
Active
Organization
CENTER FOR BRAIN-WISE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE L BADENOCH LMFT (PRESIDENT)
(360) 601-6859
Entity
Organization
Contact information
Practice address
10011 SE DIVISION ST, SUITE 312, PORTLAND, OR 97266-1351
(360) 601-6859
(360) 944-2071
Mailing address
16420 SE MCGILLIVRAY BLVD, SUITE 103, VANCOUVER, WA 98683-3461
(360) 601-6859
(360) 944-2071
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
19278
OR
Other
Enumeration date
01/20/2009
Last updated
01/20/2009
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