Metamorphosis Center for Holistic Medicine, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD12762 Issued in OR

Legal business name

METAMORPHOSIS CENTER FOR HOLISTIC MEDICINE, LLC

Practice address

5909 SE Division St
Portland, OR 97206-1470

Phone

(503) 234-1531

Fax

(503) 234-2367

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Debra Glasser Green, M.D.

Title

Owner Physician

Phone

(503) 234-1531

Specialties & licenses 1

Addresses

Other names 1

• Debra Glasser Green, M.D. Former legal business name

Locations

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386785772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5909 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061470",
            "telephone_number": "503-234-1531",
            "fax_number": "503-234-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972061470",
            "telephone_number": "503-234-1531",
            "fax_number": "503-234-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS CENTER FOR HOLISTIC MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "GLASSER",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "503-234-1531",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OR",
            "license": "MD12762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Debra Glasser Green, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jon Messinger, MD
• Lorna Hao-Teh Messinger, B.S.
• Jon Michael Hanel Messman, BA
• Sarena Mestas
• Alexandra Meszaros
• Jacob Adam Metcalf
• Samantha J Metcalf, RDH
• Anne Metcalfe
• Metolius Natural Medicine LLC
• Michele E Metrick, M.D.

• Medical Specialty Clinic/Center in Portland, OR
• Providers in Portland, OR by specialty
• Medical Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.