Provider Demographics
NPI:1497876122
Name:SOULE, LORI HORAN (ND LAC)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:HORAN
Last Name:SOULE
Suffix:
Gender:F
Credentials:ND LAC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANNA
Other - Last Name:HORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3526 SW CORBETT AVE.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:503-224-9010
Mailing Address - Fax:503-224-5551
Practice Address - Street 1:3526 SW CORBETT AVE.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239
Practice Address - Country:US
Practice Address - Phone:503-224-9010
Practice Address - Fax:503-224-5551
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00421171100000X
OR983175F00000X
OR0983175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist