Provider Demographics
NPI:1972647428
Name:KRUSCHWITZ, DOHN ROYAL (MD, ND)
Entity Type:Individual
Prefix:DR
First Name:DOHN
Middle Name:ROYAL
Last Name:KRUSCHWITZ
Suffix:
Gender:M
Credentials:MD, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 SW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5003
Mailing Address - Country:US
Mailing Address - Phone:503-552-1551
Mailing Address - Fax:503-226-8133
Practice Address - Street 1:2220 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5003
Practice Address - Country:US
Practice Address - Phone:503-552-1551
Practice Address - Fax:503-226-8133
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR911175F00000X
OR19322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR135652OtherOMAP PROVIDER NUMBER
OR135652OtherOMAP PROVIDER NUMBER