Expansive Being LLC

Primary specialty

NaturopathTaxonomy code 175F00000X

License

1435 Issued in OR

Legal business name

EXPANSIVE BEING LLC

Practice address

314 NE 19TH Ave
Portland, OR 97232-2829

Phone

(503) 239-8181

Fax

(503) 548-4013

NPI assigned

Jun 18, 2012

Organization subpart

No

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

Authorized official

Name

Jessica McManus

Title

Director of Operations

Phone

(541) 521-9151

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Amenda Clinic Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1265795991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 NE 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322829",
            "telephone_number": "503-239-8181",
            "fax_number": "503-548-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 NE 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322829",
            "telephone_number": "503-239-8181",
            "fax_number": "503-548-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPANSIVE BEING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "541-521-9151"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500671340",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amenda Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Naturopath in Portland, OR
• Providers in Portland, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.