Healthcare Provider Details

I. General information

NPI: 1881056604
Provider Name (Legal Business Name): OHANA HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 03/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 NW WESTOVER RD
PORTLAND OR
97210-3524
US

IV. Provider business mailing address

11735 NW HOLLY SPRINGS LN UNIT 104
PORTLAND OR
97229-6483
US

V. Phone/Fax

Practice location:
  • Phone: 408-209-6986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1943
License Number StateOR

VIII. Authorized Official

Name: JENNIFER TUTTLE
Title or Position: NATUROPATHIC PHYSICIAN
Credential: ND
Phone: 408-209-6986