Healthcare Provider Details

I. General information

NPI: 1114830932
Provider Name (Legal Business Name): PACIFIC POINT HEALTH AND WELLNESS PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9465 SW CHERRY LN
TUALATIN OR
97062-6011
US

IV. Provider business mailing address

9465 SW CHERRY LN
TUALATIN OR
97062-6011
US

V. Phone/Fax

Practice location:
  • Phone: 702-808-9568
  • Fax:
Mailing address:
  • Phone: 702-808-9568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA RAE HOUTROUW
Title or Position: PRESIDENT
Credential: NP
Phone: 702-808-9568