Healthcare Provider Details

I. General information

NPI: 1518679356
Provider Name (Legal Business Name): MAXIMUM HEALTH CLINIC II LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 12/22/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1832 WILLAMETTE FALLS DR
WEST LINN OR
97068-4550
US

IV. Provider business mailing address

1832 WILLAMETTE FALLS DR
WEST LINN OR
97068-4550
US

V. Phone/Fax

Practice location:
  • Phone: 503-557-8444
  • Fax: 503-557-8461
Mailing address:
  • Phone: 503-557-8444
  • Fax: 503-557-8461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: PAMELA Z. PAETZHOLD
Title or Position: OWNER/CLINIC DIRECTOR
Credential: D.C., N.D., L.AC
Phone: 503-557-8444