Dynamic Therapy Alliance, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DYNAMIC THERAPY ALLIANCE, LLC

Practice address

2404 SE 113TH Ave
Portland, OR 97216-4042

Phone

(971) 259-8022

Fax

(971) 484-4002

NPI assigned

Apr 9, 2025

Organization subpart

No

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

Authorized official

Name

Rebecca Kinman, LCSWNPI 1497489280

Title

Licensed Clinical Social Worker

Phone

(970) 258-0220

Specialties & licenses 1

Addresses

Practitioners 1

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

• Rebecca Amethyst Kinman, LCSW

  • Clinical Social Worker
  • Portland, OR
  • NPI 1497489280
  NPD Authorized official

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1356136642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 SE 113TH AVE APT A",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972164042",
            "telephone_number": "971-259-8022",
            "fax_number": "971-484-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 SE 113TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972164042",
            "telephone_number": "971-259-8022",
            "fax_number": "971-484-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC THERAPY ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "KINMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "970-258-0220",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt Dykhuizen, D.O.
• Kathryn Dykstra
• Dylan P. Booth, DDS, PC
• Dynamic Acupuncture LLC
• Dynamic Massage Therapy LLC
• Christina Dynamite, RN
• Devin Dyquisto
• Dyson Enterprises Inc
• Robert D Dyson, MD
• Diandra Dzib

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.