Organization
LIVING WELL PDX P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAX HAMMOND (ADMINISTRATOR)
(859) 410-8550
Entity
Organization
Contact information
Practice address
1920 NW AMBERGLEN PKWY, SUITE 150, BEAVERTON, OR 97006-6980
(971) 327-4355
(971) 327-4355
Mailing address
PO BOX 910544, LEXINGTON, KY 40591-0544
(859) 410-8550
(859) 223-0642
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD21275
OR
Other
Enumeration date
11/12/2012
Last updated
01/22/2013
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