=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851138382
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEX MICHAEL CULLEN ND
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2024
-----------------------------------------------------
Last Update Date | 12/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7477 SE 52ND AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97206-8206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-572-4196
-----------------------------------------------------
Fax | 833-989-2525
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7477 SE 52ND AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97206-8206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-572-4196
-----------------------------------------------------
Fax | 833-989-2525
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 175F00000X
-----------------------------------------------------
Taxonomy Name | Naturopath
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------