| Balanced Nutrition Nw Llc | |
|
20369 Homestead Dr Oregon City OR 97045-9012 | |
| (971) 419-8549 | |
| (971) 229-4024 |
| Full Name | Balanced Nutrition Nw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 20369 Homestead Dr, Oregon City, Oregon |
| Authorized Official Name and Position | Victoria Padron (REGISTERED DIETITIAN/CO-OWNER) |
| Authorized Official Contact | 9714198549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanced Nutrition Nw Llc 20369 Homestead Dr Oregon City OR 97045-9012 Ph: (971) 419-8549 | Balanced Nutrition Nw Llc 20369 Homestead Dr Oregon City OR 97045-9012 Ph: (971) 419-8549 |
| NPI Number | 1912632266 |
|---|---|
| Provider Enumeration Date | 07/20/2022 |
| Last Update Date | 07/27/2022 |
| Medicare PECOS PAC ID | 1052777984 |
|---|---|
| Medicare Enrollment ID | O20230519000892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912632266 | NPI | - | NPPES |
| 1972131001 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Victoria R Padron |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1972131001 PECOS PAC ID: 2163836677 Enrollment ID: I20210125001438 |
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