Provider Demographics
NPI:1407396658
Name:NATURAL ELEMENTS MEDICINE LLC
Entity type:Organization
Organization Name:NATURAL ELEMENTS MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:LISSETT
Authorized Official - Last Name:ROBLES HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:541-791-6537
Mailing Address - Street 1:233 3RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-2242
Mailing Address - Country:US
Mailing Address - Phone:541-791-6537
Mailing Address - Fax:541-203-7360
Practice Address - Street 1:233 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2242
Practice Address - Country:US
Practice Address - Phone:541-791-6537
Practice Address - Fax:541-203-7360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1657261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care