Provider Demographics
NPI:1598176901
Name:DR. WENDY R. ABRAHAM, LLC
Entity Type:Organization
Organization Name:DR. WENDY R. ABRAHAM, LLC
Other - Org Name:SHERWOOD NATURAL MEDICINE & REFLEXOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:971-238-4958
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-943-4180
Mailing Address - Fax:888-431-8819
Practice Address - Street 1:15922 SW 2ND ST
Practice Address - Street 2:DR. WENDY R. ABRAHAM, LLC
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9352
Practice Address - Country:US
Practice Address - Phone:971-238-4958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. WENDY R. ABRAHAM, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1303332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site