Provider Demographics
NPI:1992845622
Name:FRASER, LOIS JOST (LAC)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:JOST
Last Name:FRASER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W 11TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3754
Mailing Address - Country:US
Mailing Address - Phone:541-607-2726
Mailing Address - Fax:
Practice Address - Street 1:1650 W 11TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3754
Practice Address - Country:US
Practice Address - Phone:541-607-2726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00418171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist