Provider Demographics
NPI:1346494135
Name:ESAU, ANTHONY GEORGE (ND)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GEORGE
Last Name:ESAU
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-3363
Mailing Address - Country:US
Mailing Address - Phone:503-252-4358
Mailing Address - Fax:503-253-7765
Practice Address - Street 1:10420 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-3363
Practice Address - Country:US
Practice Address - Phone:503-252-4358
Practice Address - Fax:503-253-7765
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0739175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath