Provider Demographics
NPI:1275704215
Name:HAVLIK, MARGARET ROSE (ND)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ROSE
Last Name:HAVLIK
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:22808 SW FOREST CREEK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9690
Mailing Address - Country:US
Mailing Address - Phone:503-625-0320
Mailing Address - Fax:503-625-0326
Practice Address - Street 1:22808 SW FOREST CREEK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9690
Practice Address - Country:US
Practice Address - Phone:503-625-0320
Practice Address - Fax:503-625-0326
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1533175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath