Provider Demographics
NPI:1548080567
Name:BANYAN WELLNESS CENTER
Entity type:Organization
Organization Name:BANYAN WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELKENN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:503-741-8613
Mailing Address - Street 1:5181 W KERRY LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4938
Mailing Address - Country:US
Mailing Address - Phone:808-264-2723
Mailing Address - Fax:
Practice Address - Street 1:5 CENTERPOINTE DR STE 400
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8661
Practice Address - Country:US
Practice Address - Phone:503-741-8613
Practice Address - Fax:503-386-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty