Form Health Llc - in Portland, OR

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Form Health Llc is a Naturopath based in Portland, Oregon. Form Health Llc is licensed to practice in Oregon (license number 1517) and their current practice location is 8113 Se 13th Ave, Portland, Oregon. It can be reached at their office (for appointments etc.) via phone at (503) 232-5653.

NPI number for Form Health Llc is 1265605364 and their current mailing address is 8113 Se 13th Ave, Portland, Oregon. Form Health Llc does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1265605364.

Contact Information

Form Health Llc
8113 Se 13th Ave,
Portland, OR 97202-6607
(503) 232-5653
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameForm Health Llc
TypeFacility
SpecialityNaturopath
Location8113 Se 13th Ave, Portland, Oregon
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1265605364
  • Provider Enumeration Date: 04/09/2008
  • Last Update Date: 12/03/2025

Medical Identifiers

Medical identifiers for Form Health Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265605364NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
171100000XAcupuncturist AC01027 (Oregon)Secondary
175F00000XNaturopath 1517 (Oregon)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Form Health Llc is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Form Health Llc
8113 Se 13th Ave,
Portland, OR 97202-6607

Ph: (503) 232-5653		Form Health Llc
8113 Se 13th Ave,
Portland, OR 97202-6607

Ph: (503) 232-5653

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.