Integrated Medicine Group LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD11610 Issued in OR

Legal business name

INTEGRATED MEDICINE GROUP LLC

Practice address

163 NE 102ND Ave BLDG V
Portland, OR 97220-4169

Phone

(503) 257-3327

Fax

(503) 257-3374

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Christy Heitsch

Title

Clinic Director

Phone

(503) 257-3327

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Lara Rae Lahman, RD

  • Registered Dietitian
  • West Linn, OR
  • NPI 1639340524
  NPD (past)
• Tammy Lee Russell, RDN

  • Registered Dietitian
  • Portland, OR
  • NPI 1073701058
  NPD (past)
• Martha J Smith, LMT

  • Massage Therapist
  • Portland, OR
  • NPI 1861727661
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1679508212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 NE 102ND AVE BLDG V",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204169",
            "telephone_number": "503-257-3327",
            "fax_number": "503-257-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 NE 102ND AVE BLDG V",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204169",
            "telephone_number": "503-257-3327",
            "fax_number": "503-257-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICINE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "HEITSCH",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "503-257-3327",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "OR",
            "license": "MD11610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrate Health & Wellness: PDX, LLC
• Integrate This LLC
• Integrated Health Clinics NE LLC
• Integrated Massage by Andrea
• Integrated Medicine Group LLC
• Integrated Psychological Services of the Pacific Northwest
• Integrated Rehabiliation
• Integrated Self Counseling LLC
• Integrative Chiropractic & Wellness Spa, LLC
• Integrative Health Partners LLC

• General Practice Physician in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.