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Organization

GLOW HEALTHCARE INTEGRATIVE MEDICINE

Active
Other names
Glow HealthCare for Women
Organization subpart
No

Provider details

NPI number
Authorized official
DR. REBECCA L PROVORSE ND, L.AC (OWNER/PHYSICIAN)
(971) 407-3066
Entity
Organization

Contact information

Practice address
210 NW 17TH AVE STE 200, PORTLAND, OR 97209-2151
(971) 407-3066
(866) 842-8747
Mailing address
210 NW 17TH AVE STE 200, PORTLAND, OR 97209-2151
(971) 407-3066
(866) 842-8747

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC00861
OR
175F00000X
Naturopath
Primary
1375
OR

Other

Enumeration date
11/02/2016
Last updated
11/02/2016
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