Red Leaf Natural Health Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

1524 Issued in OR

Legal business name

RED LEAF NATURAL HEALTH CLINIC

Practice address

833 SW 11TH Ave Ste 1018
Portland, OR 97205-2124

Phone

(503) 224-2525

Fax

(503) 224-3397

NPI assigned

Apr 14, 2014

Organization subpart

No

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

Authorized official

Name

Raina Monet Lasse, ND

Title

Owner

Phone

(503) 754-8175

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1093134496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 1018",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052124",
            "telephone_number": "503-224-2525",
            "fax_number": "503-224-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 1018",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052124",
            "telephone_number": "503-224-2525",
            "fax_number": "503-224-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED LEAF NATURAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "LASSE",
        "authorized_official_first_name": "RAINA",
        "authorized_official_middle_name": "MONET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-754-8175",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "OR",
            "license": "1524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.