| Whole Life Vitality | |
|
2305 Se Washington St Suite 104 Milwaukie OR 97222-7647 | |
| (503) 482-9092 | |
| (503) 200-2259 |
| Full Name | Whole Life Vitality |
|---|---|
| Speciality | Clinic/center |
| Location | 2305 Se Washington St, Milwaukie, Oregon |
| Authorized Official Name and Position | Gibran Kekoa Ramos (OWNER) |
| Authorized Official Contact | 5034829092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Life Vitality 2305 Se Washington St Suite 104 Milwaukie OR 97222-7647 Ph: (503) 482-9092 | Whole Life Vitality 2305 Se Washington St Suite 104 Milwaukie OR 97222-7647 Ph: (503) 482-9092 |
| NPI Number | 1316236847 |
|---|---|
| Provider Enumeration Date | 04/05/2011 |
| Last Update Date | 04/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316236847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 63999099 (Oregon) | Primary |
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