Nw Functional Thyroid Clinic

LBN: Evergreen Integrative Medicine, Llc
Nw Functional Thyroid Clinic is an health care organization with primary practice located at 4926 Se Woodstock Blvd , Portland OR 97206-6163. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty. Evergreen Integrative Medicine, Llc can be contacted via phone (503) 388-6715, or through Soszka, Shawn Scott via phone (503) 388-6715.

Contact Information

Primary practice address
4926 Se Woodstock Blvd Portland OR 97206-6163
Phone: (503) 388-6715
Fax: (888) 302-5652
Website:
Map and Directions
Authorized official contact:
Name: Soszka, Shawn Scott ND, LAC
Phone: (503) 388-6715

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X 1333 Oregon

Profile Details

NPI number 1407237175
LBN Legal business name Evergreen Integrative Medicine, Llc
DBA Doing business as Nw Functional Thyroid Clinic
Authorized official Soszka, Shawn Scott ND, LAC
Entity Organization
Organization subpart 1 No
Enumeration date Jun 17th, 2015
Last updated Mar 24th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407237175 NPPES
Oregon MEDICAID 275019

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