Provider Demographics
NPI:1093568545
Name:MINDFUL BEHAVIOR JOURNEYS LLC
Entity Type:Organization
Organization Name:MINDFUL BEHAVIOR JOURNEYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-547-5344
Mailing Address - Street 1:100 SE 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3902
Mailing Address - Country:US
Mailing Address - Phone:503-547-5344
Mailing Address - Fax:503-214-8417
Practice Address - Street 1:100 SE 100TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3902
Practice Address - Country:US
Practice Address - Phone:503-547-5344
Practice Address - Fax:503-214-8417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health