Provider Demographics
NPI:1013033539
Name:EVERYDAY WELLNESS CLINIC LLC
Entity type:Organization
Organization Name:EVERYDAY WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:ND, MSOM, LAC
Authorized Official - Phone:503-222-1315
Mailing Address - Street 1:1033 SW YAMHILL ST
Mailing Address - Street 2:#300
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2545
Mailing Address - Country:US
Mailing Address - Phone:503-222-1315
Mailing Address - Fax:503-222-1317
Practice Address - Street 1:1033 SW YAMHILL ST
Practice Address - Street 2:#300
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2545
Practice Address - Country:US
Practice Address - Phone:503-222-1315
Practice Address - Fax:503-222-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00885171100000X
OR1376175F00000X
OR1371175F00000X
OR1363175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty