Healthcare Provider Details

I. General information

NPI: 1144136342
Provider Name (Legal Business Name): ALYSSA WENG ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 SE 52ND AVE STE B
PORTLAND OR
97206-3913
US

IV. Provider business mailing address

245 SW MEADE ST APT G3
PORTLAND OR
97201-4785
US

V. Phone/Fax

Practice location:
  • Phone: 971-229-2140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: