Organization · Type 2 NPI
Headlight Mental Healthcare LLC
Psychiatric/Mental Health Nurse Practitioner · Portland, OR
NPI number
1265242820
Active
Practice location
555 SE Mlk Blvd Unit 105
Portland, OR 97214-2595
Fax (541) 588-6525
Mailing address
555 SE Mlk Blvd Ste 105
Portland, OR 97214-2595
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1265242820
Headlight Mental Healthcare LLC's National Provider Identifier is 1265242820, issued on Jan 7, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Aug 24, 2026.