Provider Demographics
NPI:1891140745
Name:DONOVAN, ROSALIND (ND)
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6152 SW 45TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-3366
Mailing Address - Country:US
Mailing Address - Phone:503-403-8438
Mailing Address - Fax:888-919-3042
Practice Address - Street 1:6956 SW HAMPTON ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8351
Practice Address - Country:US
Practice Address - Phone:503-403-8438
Practice Address - Fax:888-919-3042
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4169175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath