| Northwest Vitality Group | |
|
9233 Sw 52nd Ave Portland OR 97219-5003 | |
| (503) 757-8535 | |
| (971) 223-0949 |
| Full Name | Northwest Vitality Group |
|---|---|
| Speciality | Clinic/center |
| Location | 9233 Sw 52nd Ave, Portland, Oregon |
| Authorized Official Name and Position | Holly Anne Fay (OWNER/PROVIDER/CMO) |
| Authorized Official Contact | 5037578535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Vitality Group 3 Monrow Pkwy Ste P #714 Lake Oswego OR 97035 Ph: (503) 477-5084 | Northwest Vitality Group 9233 Sw 52nd Ave Portland OR 97219-5003 Ph: (503) 757-8535 |
| NPI Number | 1033853783 |
|---|---|
| Provider Enumeration Date | 04/27/2022 |
| Last Update Date | 04/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033853783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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