Provider Demographics
NPI:1801950845
Name:GOLDEN HEART CENTER FOR WELLNESS
Entity type:Organization
Organization Name:GOLDEN HEART CENTER FOR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-232-5653
Mailing Address - Street 1:8113 SE 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6607
Mailing Address - Country:US
Mailing Address - Phone:503-232-5653
Mailing Address - Fax:503-234-6094
Practice Address - Street 1:8113 SE 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6607
Practice Address - Country:US
Practice Address - Phone:503-232-5653
Practice Address - Fax:503-234-6094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00474171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty