Provider Demographics
NPI:1629516240
Name:NATASHA S RUDD, ND, LAC, LLC DBA SAGE HEALTH CENTER
Entity Type:Organization
Organization Name:NATASHA S RUDD, ND, LAC, LLC DBA SAGE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDD
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:541-385-6249
Mailing Address - Street 1:403 NE FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4918
Mailing Address - Country:US
Mailing Address - Phone:541-385-6249
Mailing Address - Fax:541-383-4152
Practice Address - Street 1:403 NE FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4918
Practice Address - Country:US
Practice Address - Phone:541-385-6249
Practice Address - Fax:541-383-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC164231171100000X
OR2011175F00000X, 175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty