Provider Demographics
NPI:1417070616
Name:WEISS, SHANDOR (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:SHANDOR
Middle Name:
Last Name:WEISS
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 4TH ST
Mailing Address - Street 2:ARURA CLINIC OF NATURAL MEDICINE
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2043
Mailing Address - Country:US
Mailing Address - Phone:541-488-1198
Mailing Address - Fax:
Practice Address - Street 1:233 4TH ST
Practice Address - Street 2:ARURA CLINIC OF NATURAL MEDICINE
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2043
Practice Address - Country:US
Practice Address - Phone:541-488-1198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR698175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath