Organization Active NPI

Flourish Integrative Medicine

  • Nurse Practitioner
  • Portland, OR
National Provider Identifier
1366061798
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
FLOURISH INTEGRATIVE MEDICINE
Practice address
2505 SW Spring Garden St Ste 200
Portland, OR 97219-3966
Phone
(503) 432-8050
Fax
(503) 432-8025
NPI assigned
Apr 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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

Authorized official

Name
Jennifer G Owen, APRNNPI 1982969432
Title
Member
Phone
(503) 432-8050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

2505 SW Spring Garden St Ste 200
Portland, OR 97219-3966

Mailing address

2505 SW Spring Garden St Ste 200
Portland, OR 97219-3966
Phone (503) 432-8050

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2143975Flourish Integrative Medicine, LLC2505 SW Spring Garden St Suite 200, Portland, OR 97219Provider-performed microscopyFeb 7, 2028

National Provider Directory

National Provider Directory

Locations

2505 SW Spring Garden St
Ste 200
Portland, OR 97219
Phone (503) 432-8050

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1366061798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SW SPRING GARDEN ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193966",
            "telephone_number": "503-432-8050",
            "fax_number": "503-432-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 SW SPRING GARDEN ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193966",
            "telephone_number": "503-432-8050",
            "fax_number": "503-432-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOURISH INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-432-8050",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "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 Apr 15, 2020; 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.