BH-Or Op MLK, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

BH-OR OP MLK, LLC

Practice address

4943 NE Martin Luther King Blvd # 103
Portland, OR 97211-3353

Phone

(503) 504-4042

NPI assigned

Sep 11, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chad Engbrecht, ESQ

Title

General Counsel

Phone

(858) 254-2510

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1043097538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12269",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972120269",
            "telephone_number": "858-254-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4943 NE MARTIN LUTHER KING BLVD # 103",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113353",
            "telephone_number": "503-504-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BH-OR OP MLK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-11",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-09",
        "status": "A",
        "authorized_official_last_name": "ENGBRECHT",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "858-254-2510",
        "authorized_official_credential": "ESQ"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beyond the Barbell Rehab and Performance Coaching LLC
• Bezanson Psychotherapy LLC
• Jennifer Marie Bezanson, LPC
• Heather Jean Bezold
• Samuel Bezzant
• BH-Or Opco 109TH, LLC
• Nicole Bhalerao, D.C.
• Shireesh Bhalerao, D.C.
• Mona Bhalla, N.D.
• Castigliano M Bhamidipati, DO, PHD, MSC

• Adult Mental Health Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Adult Mental Health Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.