Healthcare Provider Details

I. General information

NPI: 1538005269
Provider Name (Legal Business Name): VIBRANT FAMILY WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 TWIN CREEKS XING APT A
CENTRAL POINT OR
97502-8656
US

IV. Provider business mailing address

12345 TABLE ROCK RD
CENTRAL POINT OR
97502-9375
US

V. Phone/Fax

Practice location:
  • Phone: 541-778-6321
  • Fax: 541-423-8223
Mailing address:
  • Phone: 541-778-6173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. KATIE N GUIDOTTI
Title or Position: OWNER
Credential: ND
Phone: 541-778-6173