Provider Demographics
NPI:1447655204
Name:ARBOR VITAE NATURAL HEALTH
Entity type:Organization
Organization Name:ARBOR VITAE NATURAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LESYA
Authorized Official - Middle Name:ARIKO
Authorized Official - Last Name:LASOTA
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-718-4806
Mailing Address - Street 1:827 NE ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-4578
Mailing Address - Country:US
Mailing Address - Phone:503-718-4806
Mailing Address - Fax:503-766-5979
Practice Address - Street 1:827 NE ALBERTA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-4578
Practice Address - Country:US
Practice Address - Phone:503-718-4806
Practice Address - Fax:503-766-5979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2056175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty