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Organization
MEDIPRO DIRECT SLIM, LLC
Active
Organization
MEDIPRO DIRECT SLIM, LLC
Active
Other names
MediPro Holistic Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY KYSER (OFFICE MANAGER)
(503) 828-9265
Entity
Organization
Contact information
Practice address
17933 NW EVERGREEN PKWY, SUITE 220, BEAVERTON, OR 97006-7659
(503) 828-9265
(503) 828-9054
Mailing address
17933 NW EVERGREEN PKWY STE 285, BEAVERTON, OR 97006-7513
(503) 828-9265
(503) 303-8997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
133N00000X
Nutritionist
—
NULL
133N00000X
Nutritionist
—
—
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
175F00000X
Naturopath
1430
OR
175F00000X
Naturopath
—
NULL
175F00000X
Naturopath
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/15/2013
Last updated
10/26/2022
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