Organization · Type 2 NPI

Spark Behavioral Health LLC

Clinic/Center · Portland, OR

NPI number 1376359695 Active

Practice location

11000 SW Barbur Blvd Ste 100
Portland, OR 97219-8691

Call (971) 228-9848 Map

Mailing address

4550 SW Betts Ave # 44
Beaverton, OR 97005-2869

Other practice locations

10354 NE Wasco St Ste 1, Portland, OR 97220-3927 · (971) 228-9848

Specialties and licenses

Taxonomy	Code	License
Clinic/Center Primary	261Q00000X	None listed

Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Other clinic/center providers in Portland

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NPI record

NPI: 1376359695
Entity type: Organization (Type 2)
Issued: Dec 10, 2024
Last updated: Jun 11, 2026
Status: Active

Other names

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Spark Behavioral Health LLC · doing business as
Spark Behavioral Health LLC · doing business as

Authorized official

Timnit Yikealo
Co-CEO
(971) 228-9848

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376359695

Spark Behavioral Health LLC's National Provider Identifier is 1376359695, issued on Dec 10, 2024. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Portland, OR. The record was last updated on Jun 11, 2026.