Provider Demographics
NPI:1073840195
Name:RADEMACHER, ANGELA LEA (ND, LAC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LEA
Last Name:RADEMACHER
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:CHH7
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-753-9913
Mailing Address - Fax:503-494-5385
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:CHH7
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-753-9913
Practice Address - Fax:503-494-5385
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORAC140951171100000X
OR1706175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath