Provider Demographics
NPI:1639507635
Name:DR. WENDY R. ABRAHAM
Entity Type:Organization
Organization Name:DR. WENDY R. ABRAHAM
Other - Org Name:SHERWOOD NATURAL MEDICINE & REFLEXOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
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 1:15922 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9352
Mailing Address - Country:US
Mailing Address - Phone:971-238-4958
Mailing Address - Fax:503-217-9989
Practice Address - Street 1:15922 SW 2ND ST
Practice Address - Street 2:
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:503-217-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
173C00000X
OR1303175F00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty