WHOLE LIFE VITALITY

NPI # 

Practice Address:

3942 Se Hawthorne Blvd

Portland, OR, 97214-5242

Practice Phone:

503-208-4546

Practice Fax:

503-715-5789

License Number:

63999099

License State:

OR

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Code:

261Q00000X