Organization
A BALANCED LIFE HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DEBBIE LYNN VANETT (OFFICE MANAGER)
(503) 236-4580
Entity
Organization
Contact information
Practice address
2005 SE HAWTHORNE BLVD, 20TH AND SE HAWTHORNE, PORTLAND, OR 97214-3819
(503) 236-4580
(503) 231-8400
Mailing address
2005 SE HAWTHORNE BLVD., 20TH AND SE HAWTHORNE, PORTLAND, OR 97214
(503) 236-4580
(503) 231-8400
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
020704040
OR
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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