NPIMap

Organization Active NPI

Living Well PDX P C

  • Specialist
  • Beaverton, OR
National Provider Identifier
1487998647
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD21275 Issued in OR
Legal business name
LIVING WELL PDX P C
Practice address
1920 NW Amberglen Pkwy
Suite 150
Beaverton, OR 97006-6980
Phone
(971) 327-4355
Fax
(971) 327-4355
NPI assigned
Nov 12, 2012
Last updated
Jan 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Authorized official

Name
Max HammondNPI 1316389059
Title
Administrator
Phone
(859) 410-8550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X MD21275 OR Primary

Addresses

Primary practice location

1920 NW Amberglen Pkwy
Suite 150
Beaverton, OR 97006-6980

Mailing address

PO Box 910544
Lexington, KY 40591-0544
Phone (859) 410-8550

National Provider Directory

National Provider Directory

Locations

545 SE Oak St
Ste A
Hillsboro, OR 97123
Phone (503) 640-1450

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358812800000",
    "number": "1487998647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910544",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405910544",
            "telephone_number": "859-410-8550",
            "fax_number": "859-223-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 NW AMBERGLEN PKWY",
            "address_2": "SUITE 150",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970066980",
            "telephone_number": "971-327-4355",
            "fax_number": "971-327-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL PDX P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-12",
        "last_updated": "2013-01-22",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "859-410-8550"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD21275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.