Provider Demographics
NPI:1982061404
Name:BETHEL FLORES, ND, LLC
Entity Type:Organization
Organization Name:BETHEL FLORES, ND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NATUROPATHIC DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETHEL
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-615-4055
Mailing Address - Street 1:5635 NE ELAM YOUNG PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6488
Mailing Address - Country:US
Mailing Address - Phone:503-615-4055
Mailing Address - Fax:503-615-4053
Practice Address - Street 1:5635 NE ELAM YOUNG PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6488
Practice Address - Country:US
Practice Address - Phone:503-615-4055
Practice Address - Fax:503-615-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1956175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty