Gift of Life Clinic

Primary specialty

NaturopathTaxonomy code 175F00000X

License

1481 & 1618 Issued in OR

Legal business name

GIFT OF LIFE CLINIC

Practice address

4259 NE Broadway St
Portland, OR 97213-1421

Phone

(503) 235-2259

NPI assigned

Feb 8, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mia Crupper, N.D., L.M.TNPI 1609992650

Title

Co-Owner, Naturopathic Doctor

Phone

(503) 235-2259

Specialties & licenses 3

Addresses

Practitioners 2

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

• Mia Marin- Peck Crupper, N.D., L.M.T

  • Naturopath
  • Portland, OR
  • NPI 1609992650

  Specialist

  NPD (past) Authorized official
• Michael L Crupper, N.D.

  • Naturopath
  • Portland, OR
  • NPI 1407090640
  NPD (past)

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1407128309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4259 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131421",
            "telephone_number": "503-235-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4259 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131421",
            "telephone_number": "503-235-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIFT OF LIFE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "CRUPPER",
        "authorized_official_first_name": "MIA",
        "authorized_official_title_or_position": "CO-OWNER, NATUROPATHIC DOCTOR",
        "authorized_official_telephone_number": "503-235-2259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "N.D., L.M.T"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "7621",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1481 & 1618",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": "OR",
            "license": "84-OB",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Gierach
• Julia J Gies, FNP
• Amanda Renae Giese, LCSW
• Ladawna Gievers, M.D.
• Todd A Gifford, D.M.D.
• Gifted Behavioral Health
• Gifted Soul Residential Home LLC.
• Hannah E Giger, DO
• Paul T Giger, MD
• Kelsey Giggenbach, OTD, OTR/L

• 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 Feb 8, 2012; 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.