Alive Health And Wellness, LLC
Family Medicine in Portland, OR. Organization (NPI-2).
NPI number1255167326
StatusActive
Last updated in NPPESFeb 11, 2025
Details
- NPI
- 1255167326
- Entity type
- Organization (NPI-2)
- Legal business name
- Alive Health And Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Sep 13, 2024
- Certification date
- Feb 11, 2025
- Last updated
- Feb 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
15160 Nw Laidlaw Rd Ste 222Portland, OR 97229-7708
Phone 971-470-0009 · Fax 971-470-0047
Mailing address
15160 Nw Laidlaw Rd Ste 222Portland, OR 97229-7708
Phone 971-470-0009 · Fax 971-470-0047
Authorized official
Stephanie Ruth Nani
Owner
9712949104
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