Organization
MINDFUL MOVEMENT THERAPIES LLC
Active
Other names
Mindful Movement Therapies
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTEN RAIA LINCOLN OTR/L (OWNER)
(503) 720-4634
Entity
Organization
Contact information
Practice address
4407 SW STEPHENSON ST, PORTLAND, OR 97219-7107
(503) 720-4634
(844) 250-7399
Mailing address
4407 SW STEPHENSON ST, PORTLAND, OR 97219-7107
(503) 720-4634
(844) 250-7399
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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