Provider Demographics
NPI:1801413240
Name:GFM LLC
Entity Type:Organization
Organization Name:GFM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ALLON
Authorized Official - Last Name:IRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:206-305-8709
Mailing Address - Street 1:525 SE 41ST AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3259
Mailing Address - Country:US
Mailing Address - Phone:206-305-8709
Mailing Address - Fax:
Practice Address - Street 1:1235 SE DIVISION ST STE 114
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1042
Practice Address - Country:US
Practice Address - Phone:206-305-8709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center