Organization
WATERSHED COMMUNITY WELLNESS LLC
Active
Parent organization
WATERSHED COMMUNITY WELLNESS LLC
Other names
Watershed Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
WATERSHED COMMUNITY WELLNESS LLC
Authorized official
ERIC GREY (OWNER / MEMBER)
(503) 806-5174
Entity
Organization
Contact information
Practice address
1490 COMMERCIAL ST, 202, ASTORIA, OR 97103-3800
(503) 974-0914
(888) 972-3725
Mailing address
1490 COMMERCIAL ST, 202, ASTORIA, OR 97103-3800
(503) 974-0914
(888) 972-3725
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC150225
OR
172M00000X
Mechanotherapist
12190
OR
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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