Provider Demographics
NPI:1376027466
Name:POQUETTE, SIGNE RUTH (ND)
Entity Type:Individual
Prefix:
First Name:SIGNE
Middle Name:RUTH
Last Name:POQUETTE
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 1:4424 NE GLISAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2331
Mailing Address - Country:US
Mailing Address - Phone:503-477-5167
Mailing Address - Fax:888-972-8617
Practice Address - Street 1:4424 NE GLISAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2331
Practice Address - Country:US
Practice Address - Phone:503-477-5167
Practice Address - Fax:888-972-8617
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4172175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath