WATERSHED COMMUNITY WELLNESS LLC (NPI# 1114460748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114460748 |
| Entity Type | Organization |
| Organization Name | WATERSHED COMMUNITY WELLNESS LLC |
| Other Organization Name | WATERSHED WELLNESS |
| Practice Address |
1490 Commercial St 202 Astoria OR 97103-3800 |
| Practice Telephone | 5039740914 |
| Practice Fax Number | 8889723725 |
| Mailing Telephone | 5039740914 |
| Mailing Fax Number | 8889723725 |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |
| Authorized Official Name | ERIC GREY (OWNER / MEMBER) |
| Authorized Official Telephone | 5038065174 |
| Is Organization Subpart | Y |
| Parent Organization Name | WATERSHED COMMUNITY WELLNESS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172M00000X | Mechanotherapist | 12190 | OR | Other Service Providers |
| Y | 171100000X | Acupuncturist | AC150225 | OR | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Watershed Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932436896 | Watershed Community Wellness LLC | Mechanotherapist | 1988 Se Ladd Ave, Portland, OR 97214-4737 | 2009-11-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WATERSHED COMMUNITY WELLNESS LLC | 10 Pier One Suite 308, Astoria, OR 97103 |
| Street Address |
1490 COMMERCIAL ST 202 |
| City | ASTORIA |
| State | OR |
| Zip Code | 97103-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922464650 | Mary Bess Gloria | Naturopath | 1490 Commercial St, Suite 200, Astoria, OR 97103-3800 | 2016-01-11 |
| 1821458365 | Mary Bess Gloria Nd LLC | Naturopath | 1490 Commercial St, Astoria, OR 97103-3800 | 2016-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730552845 | Kpg Oregon, LLC | Internal Medicine | 486 12th Street #200, Astoria, OR 97103 | 2015-11-11 |
| 1205239043 | Brittany Dawn Vigoren | Dental Hygienist | 433 30th St., Astoria, OR 97103 | 2014-10-08 |
| 1497188858 | Jennifer U Boggs | Counselor | 10 Pier 1 Ste 203, Astoria, OR 97103 | 2013-08-20 |
| 1780022046 | Judy J Curnow | Massage Therapist | 1 12th Street Suite 10, Astoria, OR 97103 | 2013-06-10 |
| 1659626612 | Megan Lampson | Physical Therapist | 646 16th Ave., Astoria, OR 97103 | 2012-07-16 |
| 1043580947 | Matthew Thomas Cassity | Physical Therapy Assistant | 646 16th St., Astoria, OR 97103 | 2012-01-09 |
| 1881975969 | Rebecca Nicole Roe | Contractor | 25 Whitebush Way, Astoria, OR 97103 | 2011-09-02 |
| 1346542214 | Michele Lynn Hart | Social Worker | 2120 Exchange, Astoria, OR 97103 | 2010-11-29 |
| 1447551197 | Barbara Ellen Arnold | Pharmacist | 3250 Leif Erickson Dr, Astoria, OR 97103 | 2010-11-11 |
| 1083915219 | Christina Louise Jones | Pharmacist | 3250 Lief Erickson Dr, Astoria, OR 97103 | 2010-11-04 |
| Find all providers in zip 97103 | ||||
| Taxonomy Code | 171100000X |
| Grouping | Other Service Providers |
| Classification | Acupuncturist |
| An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316563430 | Oakpoint Health & Vitality Centre | Acupuncturist | 2392 23rd St, Astoria, NY 11105-3411 | 2020-06-24 |
| 1396236782 | Nana Song | Acupuncturist | 3801 23rd Ave Unit 1, Astoria, NY 11105-1532 | 2018-05-22 |
| 1225531924 | Yuji Kim | Acupuncturist | 2275 35th St Apt D12, Astoria, NY 11105-2215 | 2018-03-09 |
| 1063912327 | Jane Christie Gibbons | Acupuncturist | 2149 45th St Fl 1, Astoria, NY 11105-1301 | 2018-02-13 |
| 1528567799 | Kazi Rubayee | Acupuncturist | 3801 23rd Ave Unit 100, Astoria, NY 11105-1532 | 2018-02-02 |
| 1184139966 | Byongsuk Kim | Acupuncturist | 2430 23rd St Fl 1, Astoria, NY 11102-2835 | 2017-12-03 |
| 1972012136 | Jungmin Choi | Acupuncturist | 2818 31st St Fl 2, Astoria, NY 11102-1745 | 2017-09-20 |
| 1871014274 | Robert Lee Integrative Chiropractic & Acupuncture, P.C. | Acupuncturist | 3089 38th St, Astoria, NY 11103-3803 | 2017-07-06 |
| 1912446964 | Alicia Halpin | Acupuncturist | 3207 31st Ave, Astoria, NY 11106-2408 | 2017-02-22 |
| 1285093682 | Ni Chung | Acupuncturist | 3815 Northern Blvd, Astoria, NY 11101-1617 | 2016-02-15 |
| Find all providers in ASTORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.