Provider Demographics
NPI:1124570726
Name:CHRISTA BARTON, ND, LLC
Entity Type:Organization
Organization Name:CHRISTA BARTON, ND, LLC
Other - Org Name:BALANCED AND BRIGHT WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-309-8855
Mailing Address - Street 1:2700 SE 26TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1288
Mailing Address - Country:US
Mailing Address - Phone:503-309-8855
Mailing Address - Fax:844-308-5008
Practice Address - Street 1:2700 SE 26TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1288
Practice Address - Country:US
Practice Address - Phone:503-309-8855
Practice Address - Fax:844-308-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-29
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3089175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty