Provider Demographics
NPI:1205372430
Name:DEMUTH, LUPIN CASCADIA (ND)
Entity Type:Individual
Prefix:DR
First Name:LUPIN
Middle Name:CASCADIA
Last Name:DEMUTH
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 1:11605 NW ROCK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97231-2412
Mailing Address - Country:US
Mailing Address - Phone:510-689-8311
Mailing Address - Fax:
Practice Address - Street 1:11605 NW ROCK CREEK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97231-2412
Practice Address - Country:US
Practice Address - Phone:510-689-8311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4050175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath