Provider Demographics
NPI:1831469329
Name:IN HEALTH NATUROPATHIC MEDICINE
Entity type:Organization
Organization Name:IN HEALTH NATUROPATHIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HANNAN
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-357-3074
Mailing Address - Street 1:1911 MOUNTAIN VIEW LN
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-2382
Mailing Address - Country:US
Mailing Address - Phone:503-357-3074
Mailing Address - Fax:503-357-2527
Practice Address - Street 1:1911 MOUNTAIN VIEW LN
Practice Address - Street 2:SUITE 200
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2382
Practice Address - Country:US
Practice Address - Phone:503-357-3074
Practice Address - Fax:503-357-2527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1398175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1396816542OtherNPI TYPE 1