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General NPI Number Information
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NPI Number | 1962872077
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Entity Type | Organization
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Legal Business Name | INFUSE HEALTH
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 1819 SW 5TH AVE SUITE 394
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City | PORTLAND
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State | OR
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Zip | 97201-5277
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Country | US
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Telephone | 503-389-8863
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Fax | 503-914-1634
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Provider Business Mailing Address
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Address Line | 1819 SW 5TH AVE SUITE 394
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City | PORTLAND
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State | OR
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Zip | 97201-5277
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Country | US
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Telephone | 503-389-8863
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Fax |
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Authorized Official
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Title or Position | FOUNDING PHYSICIAN
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Name | DR. JESSICA BRANDES
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Credential | ND
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Telephone | 503-389-8863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 3025
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License Number State | OR
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