Healthcare Provider Details

I. General information

NPI: 1326230517
Provider Name (Legal Business Name): GRESHAM NATUROPATHIC CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 NE BURNSIDE RD SUITE 702
GRESHAM OR
97030-6722
US

IV. Provider business mailing address

1217 NE BURNSIDE RD SUITE 702
GRESHAM OR
97030-6722
US

V. Phone/Fax

Practice location:
  • Phone: 503-465-9799
  • Fax: 503-489-2901
Mailing address:
  • Phone: 503-465-9799
  • Fax: 503-489-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARIS ANDREW CAMPBELL
Title or Position: OWNER
Credential: N.D.
Phone: 503-465-9799