Provider Demographics
NPI:1215587126
Name:HEALINGSPACES4U
Entity Type:Organization
Organization Name:HEALINGSPACES4U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:EUGENIA
Authorized Official - Last Name:TRAWICK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-688-3802
Mailing Address - Street 1:2951 NW DIVISION ST STE 120
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-5293
Mailing Address - Country:US
Mailing Address - Phone:503-688-3802
Mailing Address - Fax:888-887-8669
Practice Address - Street 1:2951 NW DIVISION ST STE 120
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-5293
Practice Address - Country:US
Practice Address - Phone:503-688-3802
Practice Address - Fax:888-887-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty