Organization
WELLPSYCHE PORTLAND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADEL MOSTAFAVI (CEO)
(949) 400-2488
Entity
Organization
Contact information
Practice address
4145 SW WATSON AVE STE 350, BEAVERTON, OR 97005-2191
(310) 871-0670
Mailing address
1055 WILSHIRE BLVD STE 1705, LOS ANGELES, CA 90017-5600
(310) 871-0670
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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