Provider Demographics
NPI: | 1013289529 |
---|---|
Name: | FLOW NATURAL HEALTH CARE |
Entity Type: | Organization |
Organization Name: | FLOW NATURAL HEALTH CARE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | MARSHA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HAMILTON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | ND |
Authorized Official - Phone: | 503-974-9283 |
Mailing Address - Street 1: | 11630 SE 40TH AVE |
Mailing Address - Street 2: | SUITE C |
Mailing Address - City: | MILWAUKIE |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97222-6195 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 503-974-9283 |
Mailing Address - Fax: | 503-715-0446 |
Practice Address - Street 1: | 11630 SE 40TH AVE |
Practice Address - Street 2: | SUITE C |
Practice Address - City: | MILWAUKIE |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97222-6195 |
Practice Address - Country: | US |
Practice Address - Phone: | 503-974-9283 |
Practice Address - Fax: | 503-715-0446 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-01-30 |
Last Update Date: | 2012-01-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OR | 1670 | 261QP2300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP2300X | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |