Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Broader Path Therapy LLC

Organization Clinical Social Worker · NPI 1184558033

Broader Path Therapy LLC provides Clinical Social Worker services in Portland, Oregon. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6904 N Knowles Ave
Portland, OR 97217-5117
Phone: (503) 753-0243
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1184558033
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Tallman — Owner/Therapist · (503) 753-0243
NPI enumeratedJune 8, 2026
Last updated in NPPESJuly 20, 2026
Certification dateJuly 20, 2026
Mailing address5441 S Macadam Ave Ste R, Portland, OR 97239-3822

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