Provider Demographics
NPI:1902988967
Name:BEYOND BIRTH LACTATION SERVICES
Entity type:Organization
Organization Name:BEYOND BIRTH LACTATION SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ZENANA-RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:503-232-2229
Mailing Address - Street 1:2024 SE CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202
Mailing Address - Country:US
Mailing Address - Phone:503-232-2229
Mailing Address - Fax:503-473-8047
Practice Address - Street 1:2024 SE CLINTON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202
Practice Address - Country:US
Practice Address - Phone:503-232-2229
Practice Address - Fax:503-473-8047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZENANA SPA & WELLNESS CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty