Provider Demographics
NPI:1962151027
Name:BELLSTONE MENTAL HEALTH
Entity type:Organization
Organization Name:BELLSTONE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LAMBROSE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:714-661-9032
Mailing Address - Street 1:215 VINE ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-3538
Mailing Address - Country:US
Mailing Address - Phone:714-661-9032
Mailing Address - Fax:503-387-3242
Practice Address - Street 1:6901 SE LAKE RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2102
Practice Address - Country:US
Practice Address - Phone:949-929-9799
Practice Address - Fax:503-387-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty