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Organization

VIVANTE MIDWIFERY, INC.

Active
Other names
Vivante Nurse-Midwifery, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA D. GLENN CNM, MPH, PMHNP (PRESIDENT)
(503) 652-8076
Entity
Organization

Contact information

Practice address
2625 SE HAWTHORNE BLVD, SUITE H, PORTLAND, OR 97214-2941
(503) 652-8076
(503) 922-0080
Mailing address
4110 SE HAWTHORNE BLVD, PMB 267, PORTLAND, OR 97214-5246
(503) 652-8076
(503) 922-0080

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
OR
163WP0808X
Psychiatric/Mental Health Registered Nurse
087006548N6
OR
176B00000X
Midwife
Primary
087006548N5
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010822
OR
Enumeration date
10/26/2006
Last updated
11/26/2007
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