Provider Demographics
NPI:1407173024
Name:SCHULMAN, NATHAN (LAC,OMD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:SCHULMAN
Suffix:
Gender:M
Credentials:LAC,OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5223
Mailing Address - Country:US
Mailing Address - Phone:541-687-6645
Mailing Address - Fax:541-687-6645
Practice Address - Street 1:850 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5223
Practice Address - Country:US
Practice Address - Phone:541-687-6645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01114171100000X
CAAC3139171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist