Glow Healthcare Integrative Medicine

Primary specialty

NaturopathTaxonomy code 175F00000X

License

1375 Issued in OR

Legal business name

GLOW HEALTHCARE INTEGRATIVE MEDICINE

Practice address

210 NW 17TH Ave Ste 200
Portland, OR 97209-2151

Phone

(971) 407-3066

Fax

(866) 842-8747

NPI assigned

Nov 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca L Provorse, ND, L.AC

Title

Owner/Physician

Phone

(971) 407-3066

Specialties & licenses 2

Addresses

Other names 1

• Glow HealthCare for Women Former legal business name

Locations

Practitioners 1

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

• Marcea Christine Wiggins, N.D.

  • Primary Care Clinic/Center
  • Portland, OR
  • NPI 1265601017
  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1427500784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 NW 17TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092151",
            "telephone_number": "971-407-3066",
            "fax_number": "866-842-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 NW 17TH AVE STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092151",
            "telephone_number": "971-407-3066",
            "fax_number": "866-842-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW HEALTHCARE INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "PROVORSE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "971-407-3066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND, L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00861",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glow HealthCare for Women",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jessica M Glover, LCSW, LICSW
• Kathleen Mary Glover, PNP
• Narangkar Glover, LMT
• Stephanie Glover
• Tina Marie Glover, PHD, CRC, LPC, LPCC
• Glow Midwifery
• Christine Frances Gluck, RN
• Lori Francine Gluck, MD
• Robert A Gluckman, MD
• Tyler Justin Gluckman III, M.D.

• 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 Nov 2, 2016; 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.