Watershed Community Wellness LLC

NPI #1114460748 in Astoria, Oregon

Provider Information

NPI Number: 1114460748
Entity Type: Organization
Organization Name: Watershed Community Wellness LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WATERSHED COMMUNITY WELLNESS LLC
Primary Specialty: Acupuncturist
Enumeration Date: Nov 30, 2016
Last Updated: Nov 30, 2016

Practice Location

Address: 1490 COMMERCIAL ST
Address 2: 202
City: Astoria
State: Oregon
ZIP Code: 97103-3800
Phone: (503) 974-0914

Authorized Official

Name: ERIC GREY
Title: OWNER / MEMBER
Phone: (503) 806-5174

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Mechanotherapist	172M00000X
Acupuncturist	171100000X	Primary

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