SAWUBONA, LLC (NPI# 1811519523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811519523 |
| Entity Type | Organization |
| Organization Name | SAWUBONA, LLC |
| Practice Address |
1675 Sw Marlow Ave Ste 301 Portland OR 97225-5105 |
| Mailing Address |
917 Meadows Ln Se Jefferson OR 97352-9611 |
| Practice Telephone | 5034699818 |
| Practice Fax Number | 5034699870 |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |
| Authorized Official Name | LLOYD A FOBI (MANAGING PARTER) |
| Authorized Official Telephone | 5419081117 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 175F00000X | Naturopath | Other Service Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Nutura Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SAWUBONA, LLC | 1675 Sw Marlow Ave, Portland, OR 97225 |
| Street Address |
1675 SW MARLOW AVE STE 301 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619116001 | Cathryn Luanne Selchow | Chiropractor | 1675 Sw Marlow Ave Ste 301, Portland, OR 97225-5105 | 2009-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
| 1336697143 | Rita Lawler | General Practice | 8353 Se Clatsop Ct, Portland, OR 97266-6159 | 2016-09-21 |
| 1235526849 | Hollis Lule Augee | General Practice | 5151 S.w. 88th Ave., Portland, OR 97225-1717 | 2015-04-21 |
| 1093134496 | Red Leaf Natural Health Clinic | General Practice | 833 Sw 11th Ave Ste 1018, Portland, OR 97205-2124 | 2014-04-14 |
| 1861770190 | Jeffrey Owen Pentecost | General Practice | 3574 Se Harold Ct, Portland, OR 97202-4344 | 2011-08-03 |
| 1255651592 | Nic Group Inc | General Practice | 8383 Ne Sandy Blvd Ste 320dd, Portland, OR 97220-4968 | 2010-06-09 |
| 1619296985 | Thcf | General Practice | 105 Se 18th Ave, Portland, OR 97214-1559 | 2010-05-25 |
| 1518106640 | Keith C Klopfer | General Practice | 1601 Sw Pendleton St, Portland, OR 97239-2619 | 2009-02-12 |
| 1275793424 | Harriet Cooke | General Practice | 2929 Sw Multnomah Blvd Ste 301, Portland, OR 97219-4072 | 2008-06-11 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on SAWUBONA, LLC.
| 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.