Provider Demographics
NPI:1801273511
Name:LIFEWEIGHS
Entity type:Organization
Organization Name:LIFEWEIGHS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY-NICOLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-207-7302
Mailing Address - Street 1:8835 SW CANYON LN STE 125
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-3451
Mailing Address - Country:US
Mailing Address - Phone:503-894-6004
Mailing Address - Fax:503-894-6007
Practice Address - Street 1:8835 SW CANYON LN STE 125
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-3451
Practice Address - Country:US
Practice Address - Phone:503-894-6004
Practice Address - Fax:503-894-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty