FULL BLOOM NATURAL MEDICINE LLC NPI 1871153585

NPI Information

NPI: 1871153585
Provider Name: FULL BLOOM NATURAL MEDICINE, LLC

Doing Business As: FULL BLOOM NATURAL MEDICINE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
922 NW CIRCLE BLVD STE 180
CORVALLIS, OR
ZIP 97330
Phone: (541) 224-6738
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FULL BLOOM NATURAL MEDICINE, LLC is a primary care clinic center in Corvallis, OR. FULL BLOOM NATURAL MEDICINE, LLC NPI is 1871153585. The provider is registered as an organization entity type.
The provider Is Doing Business As Full Bloom Natural Medicine.

The provider's business location address is:

922 NW CIRCLE BLVD STE 180
CORVALLIS, OR
ZIP 97330-483
Phone: (541) 224-6738

The provider's authorized official is Mary Boucher .
The authorized official title is Dr. and has the following contact phone number (541) 224-6738.

The enumeration date for this NPI number is 6/14/2019 and was last updated on 12/9/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

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

NPI Synchronization or Removal

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