Provider Demographics
NPI:1598238214
Name:WHOLE SYSTEMS HEALTHCARE
Entity Type:Organization
Organization Name:WHOLE SYSTEMS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:STUART
Authorized Official - Last Name:MEHRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:774-454-3601
Mailing Address - Street 1:4130 SW VIEW POINT TER APT 13
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4077
Mailing Address - Country:US
Mailing Address - Phone:774-454-3601
Mailing Address - Fax:
Practice Address - Street 1:1020 SW TAYLOR ST STE 340
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2508
Practice Address - Country:US
Practice Address - Phone:503-714-8924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty