| Organization Name: | RED LEAF NATURAL HEALTH CLINIC |
| NPI Number: | 1093134496 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAINA MONET LASSE (OWNER) |
| Mailing Address: | 833 Sw 11th Ave Ste 1018 Portland |
| State: | OR US |
| Postal Code: | 972052124 |
| Phone Number: | 5032242525 |
| Fax Number: | 5032243397 |
| NPI Enumeration Date: | 04/14/2014 |
| NPI Last Update Date: | 04/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1524 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |