NPIMap

Organization Active NPI

Garden Pure

  • Clinic/Center
  • Beaverton, OR
National Provider Identifier
1174801005
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
0767 Issued in OR
Legal business name
GARDEN PURE
Practice address
4085 SW 109TH Ave Ste 200
Beaverton, OR 97005-3000
Phone
(503) 643-1024
Fax
(503) 644-1293
NPI assigned
Jul 26, 2011
Last updated
Jul 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Dr. Chris D Meletis, NDNPI 1215080247
Title
Naturopathic Physician
Phone
(503) 643-1024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0767 OR Primary

Addresses

Primary practice location

4085 SW 109TH Ave Ste 200
Beaverton, OR 97005-3000

Mailing address

4085 SW 109TH Ave Ste 200
Beaverton, OR 97005-3000
Phone (503) 643-1024

Other names 1

  • Garden Pure Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1174801005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 SW 109TH AVE STE 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053000",
            "telephone_number": "503-643-1024",
            "fax_number": "503-644-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 SW 109TH AVE STE 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970053000",
            "telephone_number": "503-643-1024",
            "fax_number": "503-644-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN PURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "MELETIS",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "NATUROPATHIC PHYSICIAN",
        "authorized_official_telephone_number": "503-643-1024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "0767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden Pure",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.