Provider Demographics
NPI:1851825202
Name:VARDI TRAGASH, ORIT (ND, LAC)
Entity Type:Individual
Prefix:
First Name:ORIT
Middle Name:
Last Name:VARDI TRAGASH
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PRICE PL
Mailing Address - Street 2:SUITE 113
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3299
Mailing Address - Country:US
Mailing Address - Phone:608-335-9298
Mailing Address - Fax:
Practice Address - Street 1:313 PRICE PL
Practice Address - Street 2:SUITE 113
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3299
Practice Address - Country:US
Practice Address - Phone:608-335-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI914-55171100000X
MN1076175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist