Provider Demographics
NPI:1588325948
Name:WHOLE SYSTEMS HEALTHCARE LAKE OSWEGO CLINIC
Entity type:Organization
Organization Name:WHOLE SYSTEMS HEALTHCARE LAKE OSWEGO CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATYNA
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:TRUVAL
Authorized Official - Suffix:
Authorized Official - Credentials:ND, MPH
Authorized Official - Phone:971-979-0907
Mailing Address - Street 1:15962 BOONES FERRY RD STE 209
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-4360
Mailing Address - Country:US
Mailing Address - Phone:971-979-0907
Mailing Address - Fax:971-979-0907
Practice Address - Street 1:15962 BOONES FERRY RD STE 209
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4360
Practice Address - Country:US
Practice Address - Phone:971-979-0907
Practice Address - Fax:971-979-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty