Provider Demographics
NPI:1619563665
Name:PASSIONATE HEALTHCARE ADVOCACY & WELLNESS, LLC
Entity Type:Organization
Organization Name:PASSIONATE HEALTHCARE ADVOCACY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWIONTEK
Authorized Official - Suffix:
Authorized Official - Credentials:OTL
Authorized Official - Phone:503-201-9711
Mailing Address - Street 1:11125 SW 125TH PL
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-3508
Mailing Address - Country:US
Mailing Address - Phone:503-201-9711
Mailing Address - Fax:
Practice Address - Street 1:11125 SW 125TH PL
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-3508
Practice Address - Country:US
Practice Address - Phone:503-201-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty