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Organization

BALANCED NUTRITION NW LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICTORIA PADRON RD (REGISTERED DIETITIAN/CO-OWNER)
(971) 419-8549
Entity
Organization

Contact information

Practice address
20369 HOMESTEAD DR, OREGON CITY, OR 97045-9012
(971) 419-8549
(971) 229-4024
Mailing address
20369 HOMESTEAD DR, OREGON CITY, OR 97045-9012
(971) 419-8549
(971) 229-4024

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972131001
OR
Enumeration date
07/20/2022
Last updated
07/27/2022
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