Provider Demographics
NPI:1104231307
Name:BELLA ENTERPRISES LLC
Entity type:Organization
Organization Name:BELLA ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-946-1990
Mailing Address - Street 1:2215 SE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1244
Mailing Address - Country:US
Mailing Address - Phone:503-946-1990
Mailing Address - Fax:
Practice Address - Street 1:2215 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1244
Practice Address - Country:US
Practice Address - Phone:503-946-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2027175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty