Organization
WHOLE LIFE VITALITY
Active
Organization
WHOLE LIFE VITALITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIBRAN KEKOA RAMOS (OWNER)
(503) 482-9092
Entity
Organization
Contact information
Practice address
3942 SE HAWTHORNE BLVD, PORTLAND, OR 97214-5242
(503) 208-4546
(503) 715-5789
Mailing address
4110 SE HAWTHORNE BLVD # 178, PORTLAND, OR 97214-5246
(503) 482-9092
(503) 715-5789
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
63999099
OR
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2011
Last updated
05/23/2025
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