Provider Demographics
NPI:1285006478
Name:BRAUKER, ASHLEY LAUREN (ND)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LAUREN
Last Name:BRAUKER
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 1:2451 SE MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-3939
Mailing Address - Country:US
Mailing Address - Phone:989-400-3984
Mailing Address - Fax:
Practice Address - Street 1:18813 SW MARTINAZZI AVE
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-6807
Practice Address - Country:US
Practice Address - Phone:503-765-5265
Practice Address - Fax:503-765-5265
Is Sole Proprietor?:No
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3041175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath