Center for Brain-Wise Living

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

19278 Issued in OR

Legal business name

CENTER FOR BRAIN-WISE LIVING

Practice address

10011 SE Division St
Suite 312
Portland, OR 97266-1351

Phone

(360) 601-6859

Fax

(360) 944-2071

NPI assigned

Jan 20, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Bonnie L Badenoch, LMFT

Title

President

Phone

(360) 601-6859

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1861639312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 SE MCGILLIVRAY BLVD",
            "address_2": "SUITE 103",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833461",
            "telephone_number": "360-601-6859",
            "fax_number": "360-944-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 SE DIVISION ST",
            "address_2": "SUITE 312",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661351",
            "telephone_number": "360-601-6859",
            "fax_number": "360-944-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR BRAIN-WISE LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "BADENOCH",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-601-6859",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "19278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Cemore
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• Community/Behavioral Health Agency in Portland, OR
• Providers in Portland, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.