Organization
WELL LIFE FAMILY MEDICINE, LLC
Active
Other names
Willamette Valley Weight Loss, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUBREY LYNN HARDING ND (OWNER)
(971) 301-4411
Entity
Organization
Contact information
Practice address
1174 CORNUCOPIA ST NW STE 240, SALEM, OR 97304
(971) 301-4411
(971) 999-7006
Mailing address
1174 CORNUCOPIA ST NW STE 240, SALEM, OR 97304-3193
(971) 301-4411
(971) 999-7006
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3012
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500694138
—
OR
Enumeration date
12/19/2017
Last updated
01/07/2019
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