Provider Demographics
NPI:1013256965
Name:EVENINGSTAR NATURAL HEALTH
Entity Type:Organization
Organization Name:EVENINGSTAR NATURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTEN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-860-4338
Mailing Address - Street 1:1750 SW HARBOR WAY STE 245
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5167
Mailing Address - Country:US
Mailing Address - Phone:503-860-4338
Mailing Address - Fax:
Practice Address - Street 1:1750 SW HARBOR WAY STE 245
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5167
Practice Address - Country:US
Practice Address - Phone:503-860-4338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1820261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care