Provider Demographics
NPI:1841253457
Name:2BWELL, GROUP, LLC
Entity type:Organization
Organization Name:2BWELL, GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIAMAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-515-5225
Mailing Address - Street 1:5935 WILLOW LANE
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5344
Mailing Address - Country:US
Mailing Address - Phone:503-655-0044
Mailing Address - Fax:503-515-8099
Practice Address - Street 1:5935 WILLOW LANE
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5344
Practice Address - Country:US
Practice Address - Phone:503-655-0044
Practice Address - Fax:503-515-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1458175F00000X
ORAC00558171100000X
ORAC00307171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty