Provider Demographics
NPI:1528471349
Name:GRAIN INTEGRATIVE HEALTH, LLC
Entity type:Organization
Organization Name:GRAIN INTEGRATIVE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-445-8114
Mailing Address - Street 1:4246 SE BELMONT ST
Mailing Address - Street 2:STE. 5
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1676
Mailing Address - Country:US
Mailing Address - Phone:503-445-8114
Mailing Address - Fax:503-445-1394
Practice Address - Street 1:4246 SE BELMONT ST
Practice Address - Street 2:STE. 5
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1676
Practice Address - Country:US
Practice Address - Phone:503-445-8114
Practice Address - Fax:503-445-1394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1694175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty