=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275450298
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INNER TIDES INTEGRATIVE MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2026
-----------------------------------------------------
Last Update Date | 07/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7415 N OATMAN AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97217-1213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-495-3387
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7415 N OATMAN AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97217-1213
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-495-3387
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NATUROPATHIC DOCTOR
-----------------------------------------------------
Name | DR. RACHEL I LEBER
-----------------------------------------------------
Credential | ND
-----------------------------------------------------
Telephone | 503-495-3387
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------