Provider Demographics
NPI:1861084808
Name:THRIVE NW LLC
Entity type:Organization
Organization Name:THRIVE NW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-719-3875
Mailing Address - Street 1:910 N ALBANY RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1324
Mailing Address - Country:US
Mailing Address - Phone:503-719-3875
Mailing Address - Fax:
Practice Address - Street 1:910 N ALBANY RD NW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1324
Practice Address - Country:US
Practice Address - Phone:503-719-3875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0200XNursing Service ProvidersRegistered NursePediatricsGroup - Single Specialty