Organization · Type 2 NPI

Underdog Alchemy

Psychiatric/Mental Health Nurse Practitioner · Gresham, OR

NPI number 1720946569 Active

Practice location

22400 SE Stark St
Gresham, OR 97030-2600

Fax (971) 293-4016

Mailing address

22400 SE Stark St Ste 104
Gresham, OR 97030-2618

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XNone listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1720946569

Underdog Alchemy's National Provider Identifier is 1720946569, issued on Jan 12, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Gresham, OR. The record was last updated on Jan 12, 2026.