Provider Demographics
NPI:1659887131
Name:WIGGINS, EMILY C (ND)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:C
Last Name:WIGGINS
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 1:125 NW DELAWARE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2969
Mailing Address - Country:US
Mailing Address - Phone:458-206-3252
Mailing Address - Fax:
Practice Address - Street 1:125 NW DELAWARE AVE APT 2
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2969
Practice Address - Country:US
Practice Address - Phone:458-206-3252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR059187175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath