Organization
POSITIVE INNER SELF, LLC
Active
Organization
POSITIVE INNER SELF, LLC
Active
Other names
Mind & Body Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WILLLIS (OFFICE MANAGER)
(503) 461-3910
Entity
Organization
Contact information
Practice address
6700 SW 105TH AVE STE 215, BEAVERTON, OR 97008-8824
(971) 233-6052
(971) 277-7291
Mailing address
6700 SW 105TH AVE STE 215, BEAVERTON, OR 97008-8824
(503) 461-3910
(971) 277-7291
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
—
171400000X
Health & Wellness Coach
—
—
175F00000X
Naturopath
—
—
225700000X
Massage Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500794949
—
OR
Enumeration date
06/28/2021
Last updated
12/29/2025
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