Provider Demographics
NPI:1821489717
Name:JESSICA ANDERSON N.D. LLC
Entity Type:Organization
Organization Name:JESSICA ANDERSON N.D. LLC
Other - Org Name:RELEVE NATURAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-522-2180
Mailing Address - Street 1:9735 SW SHADY LN
Mailing Address - Street 2:SUITE 306
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5481
Mailing Address - Country:US
Mailing Address - Phone:503-522-2180
Mailing Address - Fax:
Practice Address - Street 1:9735 SW SHADY LN
Practice Address - Street 2:SUITE 306
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5481
Practice Address - Country:US
Practice Address - Phone:503-522-2180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1946175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty