Provider Demographics
NPI:1235436411
Name:A BETTER CHOICE
Entity Type:Organization
Organization Name:A BETTER CHOICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADELINE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KELL
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-772-0084
Mailing Address - Street 1:6214 SE MILWAUKIE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5417
Mailing Address - Country:US
Mailing Address - Phone:503-772-0084
Mailing Address - Fax:503-233-8995
Practice Address - Street 1:6214 SE MILWAUKIE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5417
Practice Address - Country:US
Practice Address - Phone:503-772-0084
Practice Address - Fax:503-233-8995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1299175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR277820Medicaid