Organization · Type 2 NPI

Modern Nutrition NW LLC

Health Service Clinic/Center · Portland, OR

NPI number 1235769670 Active

Practice location

7003 SE Yearling Ln
Portland, OR 97267-1983

Call (503) 650-3801 Map

Fax (503) 650-7002

Mailing address

PO Box 493
Clackamas, OR 97015-0493

Specialties and licenses

TaxonomyCodeLicense
Health Service Clinic/Center Primary 261QH0100XNone listed

Health Service Clinic/Center: Definition to come...

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About NPI 1235769670

Modern Nutrition NW LLC's National Provider Identifier is 1235769670, issued on Jan 24, 2020. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Portland, OR. The record was last updated on Aug 26, 2025.