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Organization

SACRED VESSEL NATURAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANGELA MARIE CARTER ND (CLINICAL DIRECTOR)
(503) 459-2584
Entity
Organization

Contact information

Practice address
4115 N MISSISSIPPI AVE, PORTLAND, OR 97217-3130
(503) 459-2584
(503) 893-3087
Mailing address
4115 N MISSISSIPPI AVE, PORTLAND, OR 97217-3130
(503) 459-2584
(503) 893-3087

Taxonomy

Speciality
Code
Description
License number
State
175F00000X
Naturopath
1875
OR
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500667244
OR
Enumeration date
10/05/2017
Last updated
06/16/2018
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