Organization Active NPI

Inner Brilliance

  • Clinic/Center
  • Portland, OR
National Provider Identifier
1063214559
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
INNER BRILLIANCE
Practice address
7642 SW Capitol Hwy
Portland, OR 97219-2437
Phone
(406) 750-9267
NPI assigned
Mar 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Olivia RudioNPI 1336947134
Title
Owner
Phone
(406) 750-9267

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

7642 SW Capitol Hwy
Portland, OR 97219-2437

Mailing address

10706 SW Capitol Hwy Apt 47
Portland, OR 97219-6874
Phone (406) 750-9267

National Provider Directory

National Provider Directory

Locations

7642 SW Capitol Hwy
Portland, OR 97219
Phone (971) 228-5939

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1063214559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10706 SW CAPITOL HWY APT 47",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972196874",
            "telephone_number": "406-750-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7642 SW CAPITOL HWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972192437",
            "telephone_number": "406-750-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER BRILLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "RUDIO",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-750-9267"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.