Wild Heart Natural Medicine LLC

Primary specialty

NaturopathTaxonomy code 175F00000X

Legal business name

WILD HEART NATURAL MEDICINE LLC

Practice address

5215 SW 62ND Ave
Portland, OR 97221-1176

Phone

(503) 757-6686

NPI assigned

Nov 8, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Amy Renee Jackson, ND

Title

Naturopathic Physician

Phone

(503) 757-6686

Specialties & licenses 1

Addresses

Practitioners 1

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

• JXXN Renee Montenegro, ND

  • Naturopath
  • Portland, OR
  • NPI 1922724004
  NPD

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1821706862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 SW 62ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972211176",
            "telephone_number": "503-757-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 SW 62ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972211176",
            "telephone_number": "503-757-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD HEART NATURAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "NATUROPATHIC PHYSICIAN",
        "authorized_official_telephone_number": "503-757-6686",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth E Wilcox, MD
• Tim I Wilcox, M.D.
• Elijah Wilcynski
• Wild Foliage Massage & Botanicals LLC
• Wild Hart Massage LLC
• Wild Hearts PDX
• Wild Hearts Wellness LLC
• Wild Lilac Child Development Community
• Wild Moss Wellness LLC
• Wild Naturopathic

• Naturopath in Portland, OR
• Providers in Portland, OR by specialty
• Naturopath in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.