Provider Demographics
NPI:1386883536
Name:GROWING CARE, LLC
Entity type:Organization
Organization Name:GROWING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:BARR
Authorized Official - Last Name:DESBROW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-869-3389
Mailing Address - Street 1:4004 SE WOODSTOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-7662
Mailing Address - Country:US
Mailing Address - Phone:503-777-0444
Mailing Address - Fax:
Practice Address - Street 1:4004 SE WOODSTOCK BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-7662
Practice Address - Country:US
Practice Address - Phone:503-777-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty