Healthcare Provider Details

I. General information

NPI: 1043833015
Provider Name (Legal Business Name): BEND CENTER FOR INTEGRATIVE HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2020
Last Update Date: 05/25/2020
Certification Date: 05/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 NE SAVANNAH DR STE 5
BEND OR
97701-4866
US

IV. Provider business mailing address

2660 NE HIGHWAY 20 STE 610-447
BEND OR
97701-6402
US

V. Phone/Fax

Practice location:
  • Phone: 541-668-1881
  • Fax: 888-658-6924
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTABEL G TABBADA
Title or Position: CO-OWNER
Credential: L.AC.
Phone: 541-668-1881