Provider Demographics
NPI:1093917056
Name:NYLAND, CARI ANNA (ND)
Entity Type:Individual
Prefix:
First Name:CARI
Middle Name:ANNA
Last Name:NYLAND
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 SE CLINTON ST STE E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1273
Mailing Address - Country:US
Mailing Address - Phone:503-969-6564
Mailing Address - Fax:503-230-2813
Practice Address - Street 1:2610 SE CLINTON ST STE E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1273
Practice Address - Country:US
Practice Address - Phone:503-969-6564
Practice Address - Fax:503-230-2813
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1136175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath