Provider Demographics
NPI:1144575846
Name:NATURA HEALTHCARE LLC
Entity Type:Organization
Organization Name:NATURA HEALTHCARE LLC
Other - Org Name:TERRY FONG ND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:ND, OT
Authorized Official - Phone:541-408-8930
Mailing Address - Street 1:3112 NE CROMWELL CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7606
Mailing Address - Country:US
Mailing Address - Phone:541-678-8930
Mailing Address - Fax:541-678-5312
Practice Address - Street 1:62930 O B RILEY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-9458
Practice Address - Country:US
Practice Address - Phone:541-678-5356
Practice Address - Fax:541-678-5312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1889261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service