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General NPI Number Information
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NPI Number | 1467232256
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Entity Type | Organization
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Legal Business Name | TERRAIN WELLNESS LLC
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Dates
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Enumeration Date | 09/29/2023
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 5440 SW WESTGATE DR STE 320
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City | PORTLAND
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State | OR
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Zip | 97221-2447
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Country | US
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Telephone | 503-847-9211
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Fax | 503-549-8971
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Provider Business Mailing Address
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Address Line | 5440 SW WESTGATE DR STE 320
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City | PORTLAND
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State | OR
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Zip | 97221-2447
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Country | US
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Telephone | 503-847-9211
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Fax | 503-549-8971
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIELLE S LOCKWOOD
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Credential | ND
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Telephone | 213-509-0764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2083T0002X
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Taxonomy Name | Medical Toxicology (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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