Healthcare Provider Details

I. General information

NPI: 1922396738
Provider Name (Legal Business Name): NATURAL CHOICES HEALTH CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 07/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3007 SE BELMONT ST
PORTLAND OR
97214-4026
US

IV. Provider business mailing address

3007 SE BELMONT ST
PORTLAND OR
97214-4026
US

V. Phone/Fax

Practice location:
  • Phone: 503-445-7115
  • Fax: 503-445-7116
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1053
License Number StateOR

VIII. Authorized Official

Name: JENNIFER TUFENKIAN
Title or Position: OWNER/PRACTITIONER
Credential: N.D.
Phone: 503-445-7115