Provider Demographics
NPI:1396379921
Name:BELIKOFF-STRADS, NIKOLAJS (ND)
Entity Type:Individual
Prefix:
First Name:NIKOLAJS
Middle Name:
Last Name:BELIKOFF-STRADS
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 1:25500 SE STARK ST STE 102
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-8327
Mailing Address - Country:US
Mailing Address - Phone:503-492-1327
Mailing Address - Fax:
Practice Address - Street 1:2304 SW DOLPH CT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4139
Practice Address - Country:US
Practice Address - Phone:510-502-5327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4303175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath