Healthcare Provider Details

I. General information

NPI: 1295088847
Provider Name (Legal Business Name): NCFC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2012
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SW CAMELOT CT
PORTLAND OR
97225-3700
US

IV. Provider business mailing address

2100 SW CAMELOT CT
PORTLAND OR
97225-3700
US

V. Phone/Fax

Practice location:
  • Phone: 503-252-8125
  • Fax: 503-256-8422
Mailing address:
  • Phone: 503-252-8125
  • Fax: 503-256-8422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALINA GRIMSTED
Title or Position: ADMINISTRATOR
Credential:
Phone: 503-252-8125