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General NPI Number Information
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NPI Number | 1992652333
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Entity Type | Organization
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Legal Business Name | CEDAR ROSE WELLNESS LLC
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 2512 SE 25TH AVE STE 202
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City | PORTLAND
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State | OR
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Zip | 97202-2075
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Country | US
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Telephone | 503-389-0457
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Fax | 503-389-0448
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Provider Business Mailing Address
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Address Line | 7524 SE KNIGHT ST
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City | PORTLAND
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State | OR
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Zip | 97206-5826
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Country | US
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Telephone | 503-389-0457
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Fax | 503-389-0448
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOREN ELIZABETH LUBIN
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Credential | ND, LAC
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Telephone | 503-389-0457
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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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