NPIMap

Organization Active NPI

Sawubona, LLC

Doing business as Nutura Clinic

  • General Practice Physician
  • Portland, OR
National Provider Identifier
1811519523
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SAWUBONA, LLC
Doing business as
Nutura Clinic
Practice address
1675 SW Marlow Ave Ste 301
Portland, OR 97225-5105
Phone
(503) 469-9818
Fax
(503) 469-9870
NPI assigned
May 15, 2020
Last updated
May 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
Lloyd A Fobi
Title
Managing Parter
Phone
(541) 908-1117

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X
Naturopath 175F00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1675 SW Marlow Ave Ste 301
Portland, OR 97225-5105

Mailing address

917 Meadows LN SE
Jefferson, OR 97352-9611

Other names 1

  • Nutura Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200720000197 OR Part B Supplier - Clinic/Group Practice 2668894395 Receives reassigned benefits from 4 practitioners
Practice locations: Portland, OR

National Provider Directory

National Provider Directory

Locations

8375 SW Beaverton Hillsdale Hwy
Ste 100
Portland, OR 97225
Phone (503) 298-4104

Practitioners & affiliated clinicians

Practitioners 9

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": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1811519523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 MEADOWS LN SE",
            "city": "JEFFERSON",
            "state": "OR",
            "postal_code": "973529611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE STE 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255105",
            "telephone_number": "503-469-9818",
            "fax_number": "503-469-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAWUBONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "FOBI",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTER",
        "authorized_official_telephone_number": "541-908-1117"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nutura Clinic",
            "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 May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.