Provider Demographics
NPI:1578892386
Name:JOSEPH RHINEWINE, PHD, PC
Entity Type:Organization
Organization Name:JOSEPH RHINEWINE, PHD, PC
Other - Org Name:PORTLAND MINDFULNESS THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RHINEWINE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-222-2361
Mailing Address - Street 1:522 SW 5TH AVE
Mailing Address - Street 2:STE 725
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-2133
Mailing Address - Country:US
Mailing Address - Phone:503-222-2361
Mailing Address - Fax:503-222-2395
Practice Address - Street 1:522 SW 5TH AVE
Practice Address - Street 2:STE 725
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-2133
Practice Address - Country:US
Practice Address - Phone:503-222-2361
Practice Address - Fax:503-222-2395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1754103TC0700X
OR45491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty