Provider Demographics
NPI:1639889355
Name:MOTHER TREE INTERNATIONAL LLC
Entity Type:Organization
Organization Name:MOTHER TREE INTERNATIONAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:REMER
Authorized Official - Suffix:
Authorized Official - Credentials:CD/THW DOULA
Authorized Official - Phone:503-407-4732
Mailing Address - Street 1:14146 SE HOLGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-3845
Mailing Address - Country:US
Mailing Address - Phone:503-343-9911
Mailing Address - Fax:
Practice Address - Street 1:14146 SE HOLGATE BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97236-3845
Practice Address - Country:US
Practice Address - Phone:503-343-9911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty