Provider Demographics
NPI:1134592991
Name:TOWER OF HEALTH, LLC
Entity type:Organization
Organization Name:TOWER OF HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATH/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN-ECHERD
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-464-6911
Mailing Address - Street 1:4445 SW BARBUR BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4047
Mailing Address - Country:US
Mailing Address - Phone:503-464-6911
Mailing Address - Fax:
Practice Address - Street 1:4445 SW BARBUR BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4047
Practice Address - Country:US
Practice Address - Phone:503-464-6911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2077261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR50068568Medicaid