Provider Demographics
NPI:1861665960
Name:ALL NATUROPATHIC CLINIC, LLC
Entity Type:Organization
Organization Name:ALL NATUROPATHIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAI
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN-PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-644-7100
Mailing Address - Street 1:9963 SW NIMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7150
Mailing Address - Country:US
Mailing Address - Phone:503-644-7100
Mailing Address - Fax:503-644-7110
Practice Address - Street 1:9963 SW NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7150
Practice Address - Country:US
Practice Address - Phone:503-644-7100
Practice Address - Fax:503-644-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1553175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty