Provider Demographics
NPI:1851416663
Name:MAGES, NEIL (ND)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:MAGES
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 1:3025 SW CORBETT AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-4858
Mailing Address - Country:US
Mailing Address - Phone:503-552-1551
Mailing Address - Fax:503-226-8133
Practice Address - Street 1:6655 SW HAMPTON ST
Practice Address - Street 2:STE 110
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8300
Practice Address - Country:US
Practice Address - Phone:503-684-3955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1135175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath