Provider Demographics
NPI:1780012724
Name:MARUSKA, IRIS (ND)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:
Last Name:MARUSKA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:IRIS
Other - Middle Name:
Other - Last Name:MARUSKA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ND
Mailing Address - Street 1:19075 NW TANASBOURNE DR
Mailing Address - Street 2:SUITE #200
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-5860
Mailing Address - Country:US
Mailing Address - Phone:503-684-8252
Mailing Address - Fax:866-859-8195
Practice Address - Street 1:19075 NW TANASBOURNE DR
Practice Address - Street 2:SUITE #200
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-5860
Practice Address - Country:US
Practice Address - Phone:503-684-8252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-30
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2004175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath