Healthcare Provider Details

I. General information

NPI: 1689356834
Provider Name (Legal Business Name): EACH PEACH FAMILY WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1567 SE TACOMA ST
PORTLAND OR
97202-6643
US

IV. Provider business mailing address

1567 SE TACOMA ST
PORTLAND OR
97202-6643
US

V. Phone/Fax

Practice location:
  • Phone: 971-319-3224
  • Fax: 971-402-9402
Mailing address:
  • Phone: 971-319-3224
  • Fax: 971-402-9402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHARINE GUARALDI
Title or Position: PHYSICIAN
Credential: ND
Phone: 971-319-3224