Provider Demographics
NPI:1033358023
Name:PLATT, JUDITH (LAC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:PLATT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:862 MICHELLE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1020
Mailing Address - Country:US
Mailing Address - Phone:541-482-4802
Mailing Address - Fax:
Practice Address - Street 1:862 MICHELLE AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1020
Practice Address - Country:US
Practice Address - Phone:541-482-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00739171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist