NPIMap

Organization Active NPI

Awaken Natural Medicine Inc

  • Primary Care Clinic/Center
  • Portland, OR
National Provider Identifier
1538794391
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
AWAKEN NATURAL MEDICINE INC
Doing business as
Awaken Natural Medicine Inc
Practice address
505 NW 9TH Ave
Portland, OR 97209-3578
Phone
(503) 422-6913
Fax
(888) 511-7659
NPI assigned
Mar 11, 2020
Last updated
Mar 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Authorized official

Name
Dr. Kimberly Sue Gutierrez, ND RPHNPI 1184936262
Title
Naturopathic Physician
Phone
(503) 422-6913

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

505 NW 9TH Ave
Portland, OR 97209-3578

Mailing address

505 NW 9TH Ave
Portland, OR 97209-3578
Phone (503) 422-6913

Other identifiers 1

IdentifierTypeStateIssuer
500721816MedicaidOR

Other names 1

  • Awaken Natural Medicine Inc Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ###

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1538794391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NW 9TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093578",
            "telephone_number": "503-422-6913",
            "fax_number": "888-511-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NW 9TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093578",
            "telephone_number": "503-422-6913",
            "fax_number": "888-511-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN NATURAL MEDICINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "NATUROPATHIC PHYSICIAN",
        "authorized_official_telephone_number": "503-422-6913",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND RPH"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500721816",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "###",
            "affiliation": "N",
            "address_1": "505 NW 9th Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972093578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Awaken Natural Medicine Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 11, 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.