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Contact Information

LAKESIDE SERENITY PSYCHIATRY, LLC
5441 S.MACCADAN AVE 8160
PORTLAND, OR97239
 Phone: 917-265-9614
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for LAKESIDE SERENITY PSYCHIATRY, LLC

NPI # 1366308785
LBN Legal business name LAKESIDE SERENITY PSYCHIATRY, LLC
Authorized official DALLAS UPCHURCH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/30/2025
Last updated 12/30/2025 - About 5 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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