Provider Demographics
NPI:1316627524
Name:HART NW LLC
Entity type:Organization
Organization Name:HART NW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-680-6613
Mailing Address - Street 1:7050 CHILDS RD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-7817
Mailing Address - Country:US
Mailing Address - Phone:503-680-6613
Mailing Address - Fax:
Practice Address - Street 1:7050 CHILDS RD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-7817
Practice Address - Country:US
Practice Address - Phone:503-680-6613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty