Provider Demographics
NPI:1497439749
Name:TPC REGENERATIVE HEALTH
Entity Type:Organization
Organization Name:TPC REGENERATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALITHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-574-4873
Mailing Address - Street 1:8289 SW CIRRUS DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5997
Mailing Address - Country:US
Mailing Address - Phone:503-574-4873
Mailing Address - Fax:
Practice Address - Street 1:8289 SW CIRRUS DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-5997
Practice Address - Country:US
Practice Address - Phone:503-574-4873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty