SACRED VESSEL NATURAL MEDICINE NPI 1073023941

NPI Information

SACRED VESSEL NATURAL MEDICINE is a primary care clinic center in Portland, OR. SACRED VESSEL NATURAL MEDICINE NPI is 1073023941. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4115 N MISSISSIPPI AVE
PORTLAND, OR
ZIP 97217-130
Phone: (503) 459-2584
Fax: (503) 893-3087

The provider's authorized official is Angela Marie Carter .
The authorized official title is Clinical Director and has the following contact phone number (503) 459-2584.

The enumeration date for this NPI number is 10/5/2017 and was last updated on 6/16/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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