Provider Demographics
NPI:1003199878
Name:HOREK, NATHAN (ND)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:HOREK
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 NW 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1402
Mailing Address - Country:US
Mailing Address - Phone:503-893-4704
Mailing Address - Fax:503-296-2727
Practice Address - Street 1:834 NW 19TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1402
Practice Address - Country:US
Practice Address - Phone:503-893-4703
Practice Address - Fax:503-296-2727
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1829175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath