Organization
WILDFLOWER LACTATION
Active
Organization
WILDFLOWER LACTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH E WATERS IBCLC (OWNER)
(541) 645-3018
Entity
Organization
Contact information
Practice address
3323 SW NAITO PKWY, PORTLAND, OR 97239-4672
(503) 755-8328
Mailing address
462 SW VALERIA VIEW DR APT 303, PORTLAND, OR 97225-7085
(503) 755-8328
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500820297
—
OR
Enumeration date
07/05/2024
Last updated
10/22/2025
Update your record
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