Provider Demographics
NPI:1275931461
Name:BOECK, NATALIE (ND)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:BOECK
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 1:725 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3172
Mailing Address - Country:US
Mailing Address - Phone:503-347-8394
Mailing Address - Fax:
Practice Address - Street 1:1471 PEARL ST
Practice Address - Street 2:SUITE 2
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4009
Practice Address - Country:US
Practice Address - Phone:541-338-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-20
Last Update Date:2014-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2054175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath