NPIMap

Organization Active NPI

Fettle Botanic Supply & Counsel

  • Case Management Agency
  • Portland, OR
National Provider Identifier
1689934044
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
1607 Issued in OR
Legal business name
FETTLE BOTANIC SUPPLY & COUNSEL
Practice address
3327 SE Hawthorne Blvd
Portland, OR 97214-5046
Phone
(503) 234-7801
NPI assigned
May 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Authorized official

Name
Dr. JJ Pursell
Title
President
Phone
(503) 234-7801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 1607 OR Primary

Addresses

Primary practice location

3327 SE Hawthorne Blvd
Portland, OR 97214-5046

Mailing address

3327 SE Hawthorne Blvd
Portland, OR 97214-5046

National Provider Directory

National Provider Directory

Locations

3327 SE Hawthorne Blvd
Portland, OR 97214
Phone (503) 234-7801

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1337472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1689934044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972145046",
            "telephone_number": "503-234-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FETTLE BOTANIC SUPPLY & COUNSEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-20",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "PURSELL",
        "authorized_official_first_name": "JJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-234-7801",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "OR",
            "license": "1607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 25, 2017; 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.