Provider Demographics
NPI:1477674059
Name:KACZOR, CHRISTINE (ND)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:KACZOR
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:KACZOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ND
Mailing Address - Street 1:247 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:247 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3008
Practice Address - Country:US
Practice Address - Phone:541-338-9494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1093175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath