Provider Demographics
NPI:1336641182
Name:ANKH HOLISTIC LIFE CENTER
Entity Type:Organization
Organization Name:ANKH HOLISTIC LIFE CENTER
Other - Org Name:ANKH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, HIM
Authorized Official - Phone:971-207-5652
Mailing Address - Street 1:8428 N BLISS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-1177
Mailing Address - Country:US
Mailing Address - Phone:971-207-5652
Mailing Address - Fax:
Practice Address - Street 1:8428 N BLISS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-1177
Practice Address - Country:US
Practice Address - Phone:971-207-5652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty