NPI 1407490170 · live from the CMS NPI Registry
Holistic Virtual Services
Registered Nurse, General Practice in Portland, OR. National Provider Identifier 1407490170, active.
NPI record
| NPI | 1407490170 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Registered Nurse, General Practice 163WG0000X |
| Practice location | 3439 Se Hawthorne Blvd # 906, Portland, OR 97214 |
| Practice phone | 971-999-2182 |
| Mailing address | 539 W Commerce St # 901, Dallas, TX 75208 |
| Enumerated | November 5, 2019 |
| Last updated | November 5, 2019 |
| Authorized official | Chandan Sharma, Manager |
| Other names | Holistic Virtual Services LLC |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Nutrition Support | 163WN1003X | — |
| Registered Nurse, General Practice primary | 163WG0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.