Healthcare Provider Details

I. General information

NPI: 1841992914
Provider Name (Legal Business Name): MEDICINE WITHIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61060 SUM VIEW DR
BEND OR
97702-9266
US

IV. Provider business mailing address

61060 SUM VIEW DR
BEND OR
97702-9266
US

V. Phone/Fax

Practice location:
  • Phone: 503-740-3693
  • Fax: 541-550-1995
Mailing address:
  • Phone: 503-740-3693
  • Fax: 541-550-1995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. EMMA ANDRE
Title or Position: DOCTOR
Credential: ND
Phone: 503-740-3693