Provider Demographics
NPI:1144044629
Name:ROAMING NATUROPATH
Entity type:Organization
Organization Name:ROAMING NATUROPATH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTES-SCHRAMM
Authorized Official - Suffix:
Authorized Official - Credentials:ND, DTCM
Authorized Official - Phone:916-803-7790
Mailing Address - Street 1:16812 SE POWELL BLVD APT 203
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-8705
Mailing Address - Country:US
Mailing Address - Phone:916-803-7790
Mailing Address - Fax:
Practice Address - Street 1:3535 ROSS AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3038
Practice Address - Country:US
Practice Address - Phone:408-357-3422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. LISA FORTES-SCHRAMM, ND
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center