Provider Demographics
NPI:1902500515
Name:REDEFINE, LLC
Entity type:Organization
Organization Name:REDEFINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:541-200-7773
Mailing Address - Street 1:354 NE GREENWOOD AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4638
Mailing Address - Country:US
Mailing Address - Phone:541-200-7773
Mailing Address - Fax:541-200-7816
Practice Address - Street 1:354 NE GREENWOOD AVE STE 208
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4638
Practice Address - Country:US
Practice Address - Phone:541-200-7773
Practice Address - Fax:541-200-7816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Single Specialty