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General NPI Number Information
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NPI Number | 1942919568
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Entity Type | Organization
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Legal Business Name | DOUBLETRACK NATUROPATHIC
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 9989 SW NIMBUS AVE
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City | BEAVERTON
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State | OR
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Zip | 97008-7150
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Country | US
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Telephone | 503-744-5071
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Fax | 630-869-8937
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Provider Business Mailing Address
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Address Line | 2409 SW NEBRASKA ST APT 11
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City | PORTLAND
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State | OR
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Zip | 97239-7903
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Country | US
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Telephone | 503-744-5071
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARA LOVE
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Credential | ND
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Telephone | 503-744-5071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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