Provider Demographics
NPI:1811368384
Name:OLTMAN, SAMUEL (ND)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:OLTMAN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 S MACADAM AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3518
Mailing Address - Country:US
Mailing Address - Phone:503-841-5292
Mailing Address - Fax:971-358-8095
Practice Address - Street 1:6420 S MACADAM AVE STE 208
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3518
Practice Address - Country:US
Practice Address - Phone:503-841-5292
Practice Address - Fax:971-358-8095
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3009175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath