Provider Demographics
NPI:1033549092
Name:MICH, NATALIE R (LAC)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:R
Last Name:MICH
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:1300 JOHN ADAMS ST
Mailing Address - Street 2:STE 119
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045
Mailing Address - Country:US
Mailing Address - Phone:503-868-1496
Mailing Address - Fax:503-994-0298
Practice Address - Street 1:1300 JOHN ADAMS ST
Practice Address - Street 2:STE 119
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045
Practice Address - Country:US
Practice Address - Phone:503-868-1496
Practice Address - Fax:503-994-0298
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORAC165264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500679678Medicare PIN