| Tigard Holistic Health Clinic, Llc | |
|
11930 Sw Greenburg Rd Tigard OR 97223-6453 | |
| (503) 639-1712 | |
| Not Available |
| Full Name | Tigard Holistic Health Clinic, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 11930 Sw Greenburg Rd, Tigard, Oregon |
| Authorized Official Name and Position | Stacey Lynn Raffety (OWNER) |
| Authorized Official Contact | 5036391712 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tigard Holistic Health Clinic, Llc 11930 Sw Greenburg Rd Tigard OR 97223-6453 Ph: (503) 639-1712 | Tigard Holistic Health Clinic, Llc 11930 Sw Greenburg Rd Tigard OR 97223-6453 Ph: (503) 639-1712 |
| NPI Number | 1053670117 |
|---|---|
| Provider Enumeration Date | 05/10/2012 |
| Last Update Date | 05/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053670117 | NPI | - | NPPES |
| 1003861493 | Other | OR | NATUROPATHIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 0855 (Oregon) | Primary |
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