MEDICARE: NATIONAL UNIVERSITY OF NATURAL MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	025087000	OTHER	OR	BLUE CROSS BLUE SHIELD #

General Provider Information

NPI Number	:	1730301250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL UNIVERSITY OF NATURAL MEDICINE

Provider Business Mailing Address
First Line	:	049 SW PORTER ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-4848
Country	:	US
Telephone Number	:	503-552-1551
Fax Number	:	503-295-3609

Provider Business Practice Location Address
First Line	:	3025 SW CORBETT AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97201-4858
Country	:	US
Telephone Number	:	503-552-1966
Fax Number	:	503-226-8133

Authorized Official
Title or Position	:	CMO AND DEAN OF CLINICS
Name	:	REGINA IDA DEHEN
Credential	:	NC, LAC
Telephone Number	:	503-552-1551

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	09/19/2016

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Directions to “NATIONAL UNIVERSITY OF NATURAL MEDICINE ” Practice Location

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