Provider Demographics
NPI:1952906778
Name:SYNAPTIC INTEGRATIVE CARE LLC
Entity Type:Organization
Organization Name:SYNAPTIC INTEGRATIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:971-403-0884
Mailing Address - Street 1:6536 SE DUKE ST, SUITE 7
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206
Mailing Address - Country:US
Mailing Address - Phone:971-253-4792
Mailing Address - Fax:971-358-8772
Practice Address - Street 1:6536 SE DUKE ST. SUITE 7
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206
Practice Address - Country:US
Practice Address - Phone:971-253-4792
Practice Address - Fax:971-358-8772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty