Light Side Wellness Co.
NPI 1710660956 · Psychiatric/Mental Health Nurse Practitioner · Portland, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Light Side Wellness Co. is a Psychiatric/Mental Health Nurse Practitioner organization in Portland, OR (NPI 1710660956).
Provider details
- NPI number
- 1710660956
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Steven Knott, Owner(503) 773-4673
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-08-14
- Last updated
- 2023-08-14
- Certified
- 2023-08-12
Frequently asked questions
- What is Light Side Wellness Co.'s NPI number?
- Light Side Wellness Co.'s National Provider Identifier (NPI) is 1710660956, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Light Side Wellness Co.?
- Light Side Wellness Co. is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Light Side Wellness Co. located?
- Light Side Wellness Co.'s practice location on file with NPPES is 2175 Nw Raleigh St Ste 110, Portland, OR 97210-2392.
- What is Light Side Wellness Co.'s phone number?
- The practice phone number listed in the NPPES registry for Light Side Wellness Co. is (503) 773-4673.
- Does Light Side Wellness Co. accept Medicare?
- Light Side Wellness Co. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Light Side Wellness Co.?
- The authorized official listed on Light Side Wellness Co.'s NPPES record is Steven Knott, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Light Side Wellness Co.'s NPI active?
- Yes — Light Side Wellness Co.'s NPI (1710660956) is active in the NPPES registry as of the last update on 2023-08-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.