WATERSHED COMMUNITY WELLNESS LLC NPI 1932436896

NPI Information

  • NPI: 1932436896
  • Provider Name: WATERSHED COMMUNITY WELLNESS LLC
  • Classification: Acupuncturist - 171100000X
  • Entity Type: Organization
  • Doing Business As: WATERSHED COMMUNITY WELLNESS
  • Address: 1988 SE LADD AVE
    PORTLAND, OR
    ZIP 97214
  • Phone: (503) 820-8040

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NPI Details

WATERSHED COMMUNITY WELLNESS LLC is an acupuncturist in Portland, OR. The provider is an acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. WATERSHED COMMUNITY WELLNESS LLC NPI is 1932436896. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Watershed Community Wellness.

The provider's business location address is:

1988 SE LADD AVE
PORTLAND, OR
ZIP 97214-737
Phone: (503) 820-8040
Fax: (503) 564-0180

The provider's authorized official is Eric Benjamin Grey .
The authorized official title is Member and has the following contact phone number (503) 820-8040.

The enumeration date for this NPI number is 11/12/2009 and was last updated on 1/20/2011.

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
1172M00000XMechanotherapist12190OREGONNo
2171100000XAcupuncturistAC150225OREGONYes

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: 11/21/2025

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