Eastside Wellness Center, Llc

NPI 1053504696 - Physical Therapist - 225100000X

NPI Details
NPI 1053504696
Enumeration Date 08/27/2007
Last Updated 12/13/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name NOAH I NOAH
Position OWNER
Phone (503) 445-7999
Fax (503) 445-7997
Practice Location
5331 SW MACADAM AVE
SUITE 105
PORTLAND OR, 97239-6104, US
Phone (503) 445-7999
Fax (503) 445-7997
Business Location
5331 SW MACADAM AVE
SUITE 105
PORTLAND OR, 97239-6104, US
Phone (503) 445-7999
Fax (503) 445-7997
Toxanomy
Taxonomy Code 225100000X
License State Oregon
License Number 3758
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According to our database, Eastside Wellness Center, Llc NPI is 1053504696, taxonomy code is 225100000X and license number is 3758, license state is located at Oregon. Eastside Wellness Center, Llc physically located at 5331 Sw Macadam Ave, Portland OR, 97239-6104. NPI Number 1033115704 has the healthcare provider type.

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1053504696 NPI number is provided on an as is basis without warranty of any kind. 1053504696 is maintained by the National Plan & Provider Enumeration System. The contents of Eastside Wellness Center, Llc are for informational purposes only.