Provider Demographics
NPI:1598897266
Name:FIVE ELEMENTS HEALTHCARE, INC.
Entity Type:Organization
Organization Name:FIVE ELEMENTS HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOPRANI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-241-7050
Mailing Address - Street 1:3424 NE 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2755
Mailing Address - Country:US
Mailing Address - Phone:503-241-7050
Mailing Address - Fax:503-241-7050
Practice Address - Street 1:811 NW 20TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1443
Practice Address - Country:US
Practice Address - Phone:503-241-7050
Practice Address - Fax:503-241-7050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR143171100000X
OR144171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty