Provider Demographics
NPI:1043866635
Name:HIVE MIND MEDICINE, INC
Entity Type:Organization
Organization Name:HIVE MIND MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-224-1890
Mailing Address - Street 1:520 SW 6TH AVE STE 830
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1514
Mailing Address - Country:US
Mailing Address - Phone:503-224-0443
Mailing Address - Fax:
Practice Address - Street 1:520 SW 6TH AVE STE 830
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1514
Practice Address - Country:US
Practice Address - Phone:503-224-0443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty