Organization
BASIC MINDFULNESS PORTLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANET M. SIMS PH.D. (CO-OWNER)
(503) 719-5499
Entity
Organization
Contact information
Practice address
1920 NW JOHNSON ST, SUITE 103, PORTLAND, OR 97209-1325
(503) 719-5499
Mailing address
1920 NW JOHNSON ST, SUITE 103, PORTLAND, OR 97209-1325
(503) 719-5499
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1978
OR
1041C0700X
Clinical Social Worker
4220
OR
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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