Provider Demographics
NPI:1417715921
Name:HELLSTROM PSYCHIATRY LLC
Entity Type:Organization
Organization Name:HELLSTROM PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:503-913-5629
Mailing Address - Street 1:PO BOX 283
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-0283
Mailing Address - Country:US
Mailing Address - Phone:503-913-5629
Mailing Address - Fax:
Practice Address - Street 1:44882 MISSION RD
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9293
Practice Address - Country:US
Practice Address - Phone:541-429-0550
Practice Address - Fax:541-276-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)