Mindful Growth and Wellness LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MINDFUL GROWTH AND WELLNESS LLC

Practice address

4824 NE 42ND Ave # 177
Portland, OR 97218-1661

Phone

(503) 758-9588

NPI assigned

Sep 16, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Emily Tess Demarco, MDNPI 1366882177

Title

Managing Member

Phone

(503) 758-9588

Specialties & licenses 1

Addresses

Other names 1

• Emily DeMarco, MD Doing business as

Locations

Practitioners 1

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

• Emily Tess Demarco, MD

  • Psychiatry Physician
  • Portland, OR
  • NPI 1366882177
  NPD Authorized official

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1346856200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 NE 42ND AVE # 177",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 NE 42ND AVE # 177",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181661",
            "telephone_number": "503-758-9588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL GROWTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "TESS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "503-758-9588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emily DeMarco, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mind Body Therapy
• Mind Body Therapy
• Mind Body Therapy Center, LLC
• Mind Solutions LLC
• Mindful Awakenings, LLC
• Mindful Health Northwest LLC
• Mindful Kinetics LLC
• Mindful Medicine, PC
• Mindful Mental and Behavioral Health PLLC
• Mindful Movement Rehabilitation LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.