Provider Demographics
NPI:1568535128
Name:BOVE, DAVID A (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:BOVE
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3174
Mailing Address - Country:US
Mailing Address - Phone:541-688-9988
Mailing Address - Fax:
Practice Address - Street 1:670 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4360
Practice Address - Country:US
Practice Address - Phone:541-686-9658
Practice Address - Fax:877-852-8025
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1176101YM0800X, 175F00000X
OR559171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR#227955OtherOMAP