OrganizationGlow Healthcare Integrative Medicine(<Unavail>)NaturopathOther Service ProvidersPractice Address210 NW 17th Ave Ste 200, Portland, OR 97209-2151(971) 407-3066PECOS EnrollmentBased on the most recent information from CMS, provider Glow Healthcare Integrative Medicine does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1427500784Provider TypeOrganizationFull NameGlow Healthcare Integrative MedicineOther Name<Unavail>SubpartNoEnumeration Date11/2/2016Last Updated11/2/2016Contact InformationPractice LocationPractice Address210 NW 17th Ave Ste 200, Portland, OR 97209-2151Phone(971) 407-3066Fax(866) 842-8747Mailing LocationMailing Address210 NW 17th Ave Ste 200, Portland, OR 97209-2151Phone(971) 407-3066Fax(866) 842-8747Authorized OfficialNameProvorse, Rebecca L (Owner/Physician)Phone(971) 407-3066Provider TaxonomiesCodeDescriptionLicenseCode175F00000XPrimaryDescriptionNaturopathOther Service ProvidersLicense1375OregonCode171100000XDescriptionAcupuncturistOther Service ProvidersLicenseAC00861Oregon