Provider Demographics
NPI:1992244347
Name:ALTHENA INTEGRATIVE MEDICINE INC
Entity type:Organization
Organization Name:ALTHENA INTEGRATIVE MEDICINE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GWYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGELKING
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:503-937-0060
Mailing Address - Street 1:7232 N BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-4817
Mailing Address - Country:US
Mailing Address - Phone:503-937-0060
Mailing Address - Fax:844-778-7076
Practice Address - Street 1:7232 N BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-4817
Practice Address - Country:US
Practice Address - Phone:503-937-0060
Practice Address - Fax:844-778-7076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty