Provider Demographics
NPI:1568647899
Name:LIFESTEPS NW, INC.
Entity Type:Organization
Organization Name:LIFESTEPS NW, INC.
Other - Org Name:LIFESTEPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:KALIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT, CADCII, N
Authorized Official - Phone:971-255-3276
Mailing Address - Street 1:9860 SW HALL BLVD.
Mailing Address - Street 2:SUITE E
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-290-9355
Mailing Address - Fax:503-213-6067
Practice Address - Street 1:9860 SW HALL BLVD.
Practice Address - Street 2:SUITE E
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-290-9355
Practice Address - Fax:503-213-6067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-06
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
ORC2283251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health