Provider Demographics
NPI:1700432879
Name:MARLENA KURTZ LLC
Entity Type:Organization
Organization Name:MARLENA KURTZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-489-5917
Mailing Address - Street 1:500 NW 20TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-2442
Mailing Address - Country:US
Mailing Address - Phone:503-489-5917
Mailing Address - Fax:
Practice Address - Street 1:500 NW 20TH ST STE 101
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-2442
Practice Address - Country:US
Practice Address - Phone:503-665-2344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty