Provider Demographics
NPI:1508947045
Name:GRISEZ, LAURIE ELIZABETH (ND)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ELIZABETH
Last Name:GRISEZ
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 1:365 NE GREENWOOD AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4628
Mailing Address - Country:US
Mailing Address - Phone:541-389-6935
Mailing Address - Fax:541-388-4966
Practice Address - Street 1:365 NE GREENWOOD AVE STE 3
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4628
Practice Address - Country:US
Practice Address - Phone:541-389-6935
Practice Address - Fax:541-388-4966
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1438175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath