Healthcare Provider Details

I. General information

NPI: 1760125132
Provider Name (Legal Business Name): NURTURE FAMILY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 NE ROBERTS AVE
GRESHAM OR
97030-7307
US

IV. Provider business mailing address

8630 SE KINGSWOOD WAY
DAMASCUS OR
97089-6551
US

V. Phone/Fax

Practice location:
  • Phone: 503-498-8475
  • Fax: 971-999-0671
Mailing address:
  • Phone: 503-498-8475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
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. MELISSA WOODYARD
Title or Position: OWNER/NATUROPATH
Credential: ND
Phone: 503-498-8475