Provider Demographics
NPI:1568278570
Name:YELLOW ARTICHOKE LLC
Entity type:Organization
Organization Name:YELLOW ARTICHOKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-308-1094
Mailing Address - Street 1:5331 S MACADAM AVE STE 258 PMB 508
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-308-1094
Mailing Address - Fax:503-526-8721
Practice Address - Street 1:5441 S MACADAM AVE
Practice Address - Street 2:STE N
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2947
Practice Address - Country:US
Practice Address - Phone:503-308-1094
Practice Address - Fax:503-526-8721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty