MEDIPRO DIRECT SLIM LLC NPI 1457692444

NPI Information

MEDIPRO DIRECT SLIM, LLC is a multi-specialty clinic center in Beaverton, OR. MEDIPRO DIRECT SLIM, LLC NPI is 1457692444. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Medipro Holistic Health.

The provider's business location address is:

17933 NW EVERGREEN PKWY
SUITE 220
BEAVERTON, OR
ZIP 97006-659
Phone: (503) 828-9265
Fax: (503) 828-9054

The provider's authorized official is Kelly Kyser .
The authorized official title is Office Manager and has the following contact phone number (503) 828-9265.

The CLIA number assigned to this NPI record is 38D2213926 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2013 and was last updated on 10/26/2022.

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:

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