Provider Demographics
NPI:1225571706
Name:LIFE ENCOUNTER COUNSELING
Entity Type:Organization
Organization Name:LIFE ENCOUNTER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:503-706-6426
Mailing Address - Street 1:7175 SW BEVELAND RD
Mailing Address - Street 2:110
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8665
Mailing Address - Country:US
Mailing Address - Phone:503-706-6426
Mailing Address - Fax:503-536-6768
Practice Address - Street 1:7175 SW BEVELAND RD
Practice Address - Street 2:110
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8665
Practice Address - Country:US
Practice Address - Phone:503-706-6426
Practice Address - Fax:503-536-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2114251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health