Provider Demographics
NPI:1073010880
Name:ALDER, ANTON LYNN (ND)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:LYNN
Last Name:ALDER
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:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-0211
Mailing Address - Country:US
Mailing Address - Phone:541-567-6277
Mailing Address - Fax:541-567-9055
Practice Address - Street 1:1002 W ELM AVE
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838
Practice Address - Country:US
Practice Address - Phone:541-567-6277
Practice Address - Fax:541-567-9055
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4157175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath