Provider Demographics
NPI:1497020754
Name:MCDOWELL, MISTY (ND)
Entity Type:Individual
Prefix:DR
First Name:MISTY
Middle Name:
Last Name:MCDOWELL
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 1:7194 SW MCDONALD DR
Mailing Address - Street 2:#107
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-6520
Mailing Address - Country:US
Mailing Address - Phone:541-974-7812
Mailing Address - Fax:
Practice Address - Street 1:7194 SW MCDONALD DR
Practice Address - Street 2:#107
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-6520
Practice Address - Country:US
Practice Address - Phone:541-974-7812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1852175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1852OtherSTATE OF OREGON BOARD OF NATUROPATHIC MEDICINE