Provider Demographics
NPI:1235699489
Name:STEIN, MELANIE (ND)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:STEIN
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 1:16750 SW JORDAN WAY
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-1842
Mailing Address - Country:US
Mailing Address - Phone:503-780-6921
Mailing Address - Fax:
Practice Address - Street 1:16750 SW JORDAN WAY
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-1842
Practice Address - Country:US
Practice Address - Phone:503-780-6921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-22
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4240175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty