| Alive Health And Wellness, Llc | |
|
15160 Nw Laidlaw Rd Ste 222 Portland OR 97229-7708 | |
| (971) 470-0009 | |
| (971) 470-0047 |
| Full Name | Alive Health And Wellness, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 15160 Nw Laidlaw Rd Ste 222, Portland, Oregon |
| Authorized Official Name and Position | Stephanie Ruth Nani (OWNER) |
| Authorized Official Contact | 9712949104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alive Health And Wellness, Llc 15160 Nw Laidlaw Rd Ste 222 Portland OR 97229-7708 Ph: (971) 470-0009 | Alive Health And Wellness, Llc 15160 Nw Laidlaw Rd Ste 222 Portland OR 97229-7708 Ph: (971) 470-0009 |
| NPI Number | 1255167326 |
|---|---|
| Provider Enumeration Date | 09/13/2024 |
| Last Update Date | 02/11/2025 |
| Medicare PECOS PAC ID | 3678094620 |
|---|---|
| Medicare Enrollment ID | O20250306000313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255167326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Julieta Arredondo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942901673 PECOS PAC ID: 9537526876 Enrollment ID: I20230601001653 |
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