Provider Demographics
NPI:1043464100
Name:SHERWOOD NATUROPATHIC MEDICINE, LLC
Entity Type:Organization
Organization Name:SHERWOOD NATUROPATHIC MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HAVLIK
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-625-0320
Mailing Address - Street 1:22808 SW FOREST CREEK DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9692
Mailing Address - Country:US
Mailing Address - Phone:503-625-0320
Mailing Address - Fax:
Practice Address - Street 1:22808 SW FOREST CREEK DR UNIT 102
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9692
Practice Address - Country:US
Practice Address - Phone:503-625-0320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1533175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty