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EXPANSIVE BEING LLC NPI 1265795991


NPI Information

NPI: 1265795991
Provider Name: EXPANSIVE BEING LLC

Doing Business As: AMENDA CLINIC

Classification: Naturopath - 175F00000X
Entity Type: Organization

CLIA Number: 38D2287426

Address:
314 NE 19TH AVE
PORTLAND, OR
ZIP 97232
Phone: (503) 239-8181
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EXPANSIVE BEING LLC is a naturopath in Portland, OR. The provider is diagnoses, treats, and cares for patients, using system of practice that bases treatment of physiological functions and abnormal conditions on natural laws governing human body: Utilizes physiological, psychological, and mechanical methods, such as air, water, light, heat, earth, phototherapy, food and herb therapy, psychotherapy, electrotherapy, physiotherapy, minor and orificial surgery, mechanotherapy, naturopathic corrections and manipulation, and natural methods or modalities, together with natural medicines, natural processed foods, and herbs and nature's remedies. Excludes major surgery, therapeutic use of x ray and radium, and use of drugs, except those assimilable substances containing elements or compounds which are components of body tissues and are physiologically compatible to body processes for maintenance of life. EXPANSIVE BEING LLC NPI is 1265795991. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Amenda Clinic.

The provider's business location address is:

314 NE 19TH AVE
PORTLAND, OR
ZIP 97232-829
Phone: (503) 239-8181
Fax: (503) 548-4013

The provider's authorized official is Jessica Mcmanus .
The authorized official title is Director Of Operations and has the following contact phone number (541) 521-9151.

The CLIA number assigned to this NPI record is 38D2287426 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/18/2012 and was last updated on 5/18/2021.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1133N00000XNutritionistNo
2175F00000XNaturopath1435OREGONYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1500671340MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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