Provider Demographics
NPI:1639438229
Name:AI-ZEN LLC.
Entity Type:Organization
Organization Name:AI-ZEN LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-431-1414
Mailing Address - Street 1:5035 NE ELAM YOUNG PKWY
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6425
Mailing Address - Country:US
Mailing Address - Phone:503-693-1151
Mailing Address - Fax:503-693-1153
Practice Address - Street 1:5035 NE ELAM YOUNG PKWY STE 500
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6473
Practice Address - Country:US
Practice Address - Phone:503-693-1151
Practice Address - Fax:503-693-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17920225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty