Provider Demographics
NPI: | 1871191106 |
---|---|
Name: | MAANSI FAMILY HEALTH CENTER |
Entity type: | Organization |
Organization Name: | MAANSI FAMILY HEALTH CENTER |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KHIVAN |
Authorized Official - Middle Name: | KAUR |
Authorized Official - Last Name: | OBEROI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | ND |
Authorized Official - Phone: | 503-780-5765 |
Mailing Address - Street 1: | 8111 SW CORAL BELL CT |
Mailing Address - Street 2: | |
Mailing Address - City: | BEAVERTON |
Mailing Address - State: | OR |
Mailing Address - Zip Code: | 97008-4202 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 503-780-5765 |
Mailing Address - Fax: | 503-200-1037 |
Practice Address - Street 1: | 960 LIBERTY ST SE STE 210 |
Practice Address - Street 2: | |
Practice Address - City: | SALEM |
Practice Address - State: | OR |
Practice Address - Zip Code: | 97302-4195 |
Practice Address - Country: | US |
Practice Address - Phone: | 503-893-8905 |
Practice Address - Fax: | 503-200-1037 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-10-09 |
Last Update Date: | 2024-10-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
No | 175F00000X | Other Service Providers | Naturopath | Group - Single Specialty |