Provider Demographics
NPI:1922487511
Name:GLOBAL INTEGRATIVE MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:GLOBAL INTEGRATIVE MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HENSON
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-548-4008
Mailing Address - Street 1:1585 SW MARLOW AVE
Mailing Address - Street 2:200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5176
Mailing Address - Country:US
Mailing Address - Phone:503-548-4008
Mailing Address - Fax:503-802-2629
Practice Address - Street 1:1585 SW MARLOW AVE
Practice Address - Street 2:200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5176
Practice Address - Country:US
Practice Address - Phone:503-548-4008
Practice Address - Fax:503-802-2629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1480261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care