Individual provider · Type 1 NPI

Sophie Ray Ireene Levine

Mental Health Counselor · Portland, OR

NPI number 1679444533 Active

Practice location

12505 SE Raymond St
Portland, OR 97236-3931

Fax (503) 760-8308

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1679444533

Sophie Ray Ireene Levine's National Provider Identifier is 1679444533, issued on Sep 15, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Sep 15, 2025.