WATERSHED COMMUNITY WELLNESS LLC (NPI# 1932436896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932436896 |
| Entity Type | Organization |
| Organization Name | WATERSHED COMMUNITY WELLNESS LLC |
| Other Organization Name | WATERSHED COMMUNITY WELLNESS |
| Practice Address |
1988 Se Ladd Ave Portland OR 97214-4737 |
| Practice Telephone | 5038208040 |
| Practice Fax Number | 5035640180 |
| Mailing Telephone | 5038208040 |
| Mailing Fax Number | 5035640180 |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2011-01-20 |
| Authorized Official Name | MR. ERIC BENJAMIN GREY (MEMBER) |
| Authorized Official Telephone | 5038208040 |
| Authorized Official Credential | LAC |
| Is Organization Subpart | N |
| 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 Community Wellness | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114460748 | Watershed Community Wellness LLC | Mechanotherapist | 1490 Commercial St, 202, Astoria, OR 97103-3800 | 2016-11-30 |
| 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 |
1988 SE LADD AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97214-4737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407093628 | Donovan Joseph Monroe | Massage Therapist | 1988 Se Ladd Ave, Portland, OR 97214-4737 | 2009-01-09 |
| 1598032047 | Shen Ming Healing Arts, Inc. | Acupuncturist | 1988 Se Ladd Ave, Portland, OR 97214-4737 | 2011-11-29 |
| 1699083329 | Brandon William Brown | Acupuncturist | 1988 Se Ladd Ave, Portland, OR 97214-4737 | 2010-09-15 |
| 1689907875 | Eric B Grey | Acupuncturist | 1988 Se Ladd Ave, Portland, OR 97214-4737 | 2009-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1336772243 | Alexandra Mcbryde | Acupuncturist | 959 Se Division St, #315, Portland, OR 97214 | 2020-02-19 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1639616436 | Erin Elizabeth Weaver | Acupuncturist | 1330 Se Cesar E Chavez Blvd. Center for Natural Meidici, Portland, OR 97214 | 2017-01-31 |
| 1780126045 | Katherine Aravamudan, Lpc, LLC | Community/Behavioral Health | 1312 E. Burnside Street, Portland, OR 97214 | 2016-11-17 |
| 1003358441 | Michelle Jean Meadows | Massage Therapist | 2804 Se Lincoln St, Portland, OR 97214 | 2016-11-16 |
| 1629429311 | Stephanie Tolentino | Counselor | 605 Se Cesar E Chavez Blvd., Portland, OR 97214 | 2016-06-24 |
| 1790141166 | Marian Iris Dixon | Massage Therapist | 3810 Se Belmont St., Earthbody Wellness Center East, Portland, OR 97214 | 2016-01-14 |
| 1194194589 | Lutheran Community Services Northwest | Community/Behavioral Health | 605 Se Cesar E Chavez Bld, Portland, OR 97214 | 2015-09-16 |
| 1497123566 | Michele R. Stokes | Specialist | 2311 East Burnside B1, Portland, OR 97214 | 2015-09-08 |
| Find all providers in zip 97214 | ||||
| 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 |
|---|---|---|---|---|
| 1669073490 | Krista Marie Obenlock | Acupuncturist | 2408 N Baldwin St, Portland, OR 97217-6404 | 2020-11-06 |
| 1841897550 | Woven Wellness LLC | Acupuncturist | 6511 N Interstate Ave, Portland, OR 97217-4835 | 2020-10-06 |
| 1518571322 | Charisse Renee Squires | Acupuncturist | 1804 Se Oak St, Portland, OR 97214-1538 | 2020-08-31 |
| 1659989069 | Touchet Acupuncture | Acupuncturist | 4605 Ne Fremont St Ste 204a, Portland, OR 97213-1715 | 2020-07-22 |
| 1417571480 | Dragon Rises Center for Wholeness | Acupuncturist | 4852 Sw Scholls Ferry Rd, Portland, OR 97225-1698 | 2020-06-04 |
| 1972126191 | Acupuncture By Maya Martinez LLC | Acupuncturist | 12732 Se Stark St Bldg G, Portland, OR 97233-1539 | 2020-05-21 |
| 1437771854 | Hannah Grice | Acupuncturist | 11750 Sw Barnes Rd Ste 240, Portland, OR 97225-5911 | 2020-05-07 |
| 1164043022 | Michelle Yan | Acupuncturist | 2855 Nw Thurman St, Portland, OR 97210-2206 | 2020-05-01 |
| 1174144562 | Dean Mcnash | Acupuncturist | 2222 Se Woodward St, Portland, OR 97202-2157 | 2020-04-27 |
| 1205456548 | Zev J Alpert | Acupuncturist | 3150 Sw Bertha Blvd Apt 11, Portland, OR 97239-1181 | 2020-04-16 |
| Find all providers in PORTLAND | ||||
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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.