Provider Demographics
NPI:1629527148
Name:LUND, ROBERT (ND)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:LUND
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 E AIRPORT RD # 111
Mailing Address - Street 2:#111
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3094
Mailing Address - Country:US
Mailing Address - Phone:541-401-4013
Mailing Address - Fax:541-451-4673
Practice Address - Street 1:7380 S EASTERN AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1550
Practice Address - Country:US
Practice Address - Phone:541-401-4013
Practice Address - Fax:541-451-4673
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060704175F00000X
GA060704175F00000X
NV175F00000X
NV06704175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath