Organization
FOREST MEDICINE LLC
Active
Parent organization
94985497
Other names
Water of Life Natural Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
94985497
Authorized official
DR. KATHRYN OLIVIA KLOOS N.D. (OWNER)
(503) 250-0440
Entity
Organization
Contact information
Practice address
22400 SE STARK ST STE 105, GRESHAM, OR 97030-2656
(503) 250-0440
Mailing address
PO BOX 116, CORBETT, OR 97019-0116
(503) 250-0440
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
1798
OR
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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