Provider Demographics
NPI:1033634639
Name:IFINISH STRONG LLC
Entity Type:Organization
Organization Name:IFINISH STRONG LLC
Other - Org Name:IFINISH STRONG LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ABD
Authorized Official - Phone:541-579-6113
Mailing Address - Street 1:10260 SW GREENBURG RD STE 400
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5514
Mailing Address - Country:US
Mailing Address - Phone:971-264-0649
Mailing Address - Fax:541-320-9053
Practice Address - Street 1:10260 SW GREENBURG RD STE 10260SW
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-5500
Practice Address - Country:US
Practice Address - Phone:458-210-2982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-04
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500679772Medicaid