NPIMap

Organization Active NPI

A Balanced Life Health Care

  • Health Maintenance Organization
  • Portland, OR
National Provider Identifier
1083040869
Registry record updated Sep 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
020704040 Issued in OR
Legal business name
A BALANCED LIFE HEALTH CARE
Practice address
2005 SE Hawthorne Blvd
20TH and SE Hawthorne
Portland, OR 97214-3819
Phone
(503) 236-4580
Fax
(503) 231-8400
NPI assigned
Sep 24, 2013
Last updated
Sep 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Debbie Lynn Vanett
Title
Office Manager
Phone
(503) 236-4580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 020704040 OR Primary

Addresses

Primary practice location

2005 SE Hawthorne Blvd
20TH and SE Hawthorne
Portland, OR 97214-3819

Mailing address

2005 SE Hawthorne Blvd.
20TH and SE Hawthorne
Portland, OR 97214
Phone (503) 236-4580

National Provider Directory

National Provider Directory

Locations

2005 SE Hawthorne Blvd
Portland, OR 97214
Phone (503) 236-4580

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379980800000",
    "number": "1083040869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 SE HAWTHORNE BLVD.",
            "address_2": "20TH AND SE HAWTHORNE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-236-4580",
            "fax_number": "503-231-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 SE HAWTHORNE BLVD",
            "address_2": "20TH AND SE HAWTHORNE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143819",
            "telephone_number": "503-236-4580",
            "fax_number": "503-231-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BALANCED LIFE HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A",
        "authorized_official_last_name": "VANETT",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-236-4580",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "OR",
            "license": "020704040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.