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General NPI Number Information
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NPI Number | 1902201130
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Entity Type | Organization
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Legal Business Name | RADIANT HEART CENTER FOR WHOLENESS
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 2403 SE MONROE ST SUITE B
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City | MILWAUKIE
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State | OR
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Zip | 97222-7646
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Country | US
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Telephone | 503-303-4078
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Fax |
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Provider Business Mailing Address
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Address Line | 2403 SE MONROE ST SUITE B
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City | MILWAUKIE
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State | OR
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Zip | 97222-7646
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Country | US
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Telephone | 503-303-4078
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. ALLISON EMIKO GIVENS
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Credential | ND
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Telephone | 971-227-3899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC152866
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 1576
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License Number State | OR
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