Provider Demographics
NPI:1669842522
Name:LUBIN, LOREN ELIZABETH (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:ELIZABETH
Last Name:LUBIN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:LOREN
Other - Middle Name:ELIZABETH
Other - Last Name:BANACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2704 SE 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1606
Mailing Address - Country:US
Mailing Address - Phone:347-844-1254
Mailing Address - Fax:
Practice Address - Street 1:2348 NW LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3022
Practice Address - Country:US
Practice Address - Phone:503-224-7224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-03
Last Update Date:2015-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC174668171100000X
OR3028175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist