# ODYSSEY SCIENCE INNOVATIONS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Provata Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255793519
- **Authorized official:** MR. ALEX GOLDBERG (CEO)
- **Authorized official phone:** (503) 577-7571

## Contact information

- **Practice address:** 6 CENTERPOINTE DR STE 450, LAKE OSWEGO, OR 97035-8621
- **Practice address phone:** (503) 489-8929
- **Mailing address:** 6 CENTERPOINTE DR STE 450, LAKE OSWEGO, OR 97035-8621
- **Mailing address phone:** (503) 489-8929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 03/25/2016
- **Last updated:** 03/25/2016