Provider Demographics
NPI:1992039507
Name:CLEVELAND-JOB, EMILY FERRELL (ND)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:FERRELL
Last Name:CLEVELAND-JOB
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 1:103 DISSTON RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-4041
Mailing Address - Country:US
Mailing Address - Phone:503-384-8315
Mailing Address - Fax:503-328-7083
Practice Address - Street 1:2135 NE 55TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2622
Practice Address - Country:US
Practice Address - Phone:503-384-8315
Practice Address - Fax:503-328-7083
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1684175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath