Provider Demographics
NPI:1225879356
Name:BEND HOLISTIC HEALTH CARE, PC
Entity type:Organization
Organization Name:BEND HOLISTIC HEALTH CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:TRANG
Authorized Official - Last Name:LAM-QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:458-256-9594
Mailing Address - Street 1:132 SW CROWELL WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1178
Mailing Address - Country:US
Mailing Address - Phone:458-256-9594
Mailing Address - Fax:530-316-5921
Practice Address - Street 1:132 SW CROWELL WAY STE 101
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1178
Practice Address - Country:US
Practice Address - Phone:458-256-9594
Practice Address - Fax:530-316-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care