SACRED PSYCHIATRY, LLC
NPI 1952996076
Clinic/Center - Mental Health (Including Community Mental Health Center) in Portland, OR
Active since March 02, 2021
About Sacred Psychiatry, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SACRED PSYCHIATRY, LLC (NPI 1952996076) is a healthcare organization registered as a mental health (including community mental health center) in Portland, Oregon and active in the NPI registry since March 2021. The organization lists Roosevelt Lewis, Owner, as its authorized official.
NPPES Registry Identity
NPI1952996076
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameSACRED PSYCHIATRY, LLC
Location Address1717 NE 42ND AVE STE 100EPortland, OR 97213-1569
Mailing Address1717 Ne 42nd Ave Ste 100ePortland, OR 97213-1569 · (503) 498-6455
Phone(503) 498-6455
Organization SubpartNo
Authorized OfficialRoosevelt LewisOwner · (503) 498-6455
Enumeration DateMarch 2, 2021
NPPES CertifiedMarch 2, 2021
✔ NPI 1952996076 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
1717 NE 42ND AVE STE 100E, Portland, OR 97213
Group Practice 1
Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1952996076, enumerated as an "organization" on March 02, 2021.
The provider is located at 1717 NE 42ND AVE STE 100E PORTLAND, OR 97213 and the phone number is (503) 498-6455.
Clinic/Center with taxonomy code 261QM0801X and a focus in Mental Health (Including Community Mental Health Center).
