Provider Demographics
NPI:1528379286
Name:DUCAT, STEPHEN J (ND, PHD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:DUCAT
Suffix:
Gender:M
Credentials:ND, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 NW HIGH LAKES LOOP
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-6968
Mailing Address - Country:US
Mailing Address - Phone:415-451-7056
Mailing Address - Fax:541-633-7708
Practice Address - Street 1:2401 NW HIGH LAKES LOOP
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-6968
Practice Address - Country:US
Practice Address - Phone:415-451-7056
Practice Address - Fax:541-633-7708
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-180175F00000X
CAPSY 14896103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No103T00000XBehavioral Health & Social Service ProvidersPsychologist