Healthcare Provider Details

I. General information

NPI: 1376794008
Provider Name (Legal Business Name): SEVEN CIRCLES NATURAL MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 05/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5819 N GREELEY AVE STE 101
PORTLAND OR
97217-4159
US

IV. Provider business mailing address

5819 N GREELEY AVE STE 101
PORTLAND OR
97217-4159
US

V. Phone/Fax

Practice location:
  • Phone: 503-278-3385
  • Fax: 503-278-3386
Mailing address:
  • Phone: 503-278-3385
  • Fax: 503-278-3386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number1676
License Number StateOR

VIII. Authorized Official

Name: DR. MARLEEN HAVERTY
Title or Position: OWNER
Credential: ND, LAC
Phone: 503-278-3385