Provider Demographics
NPI:1699529263
Name:TERRAIN NATURAL MEDICINE LLC
Entity type:Organization
Organization Name:TERRAIN NATURAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENDAHL
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:541-797-0013
Mailing Address - Street 1:209 NE GREENWOOD AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4652
Mailing Address - Country:US
Mailing Address - Phone:541-797-0013
Mailing Address - Fax:866-206-2619
Practice Address - Street 1:209 NE GREENWOOD AVE STE 200
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4652
Practice Address - Country:US
Practice Address - Phone:541-797-0013
Practice Address - Fax:866-206-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty