Provider Demographics
NPI:1013217439
Name:ANDRE, EMMA LOUISE (ND)
Entity Type:Individual
Prefix:DR
First Name:EMMA
Middle Name:LOUISE
Last Name:ANDRE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:DR
Other - First Name:EMMA
Other - Middle Name:LOUISE
Other - Last Name:THORBORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:61060 SUM VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9266
Mailing Address - Country:US
Mailing Address - Phone:503-740-3693
Mailing Address - Fax:
Practice Address - Street 1:61060 SUM VIEW DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-9266
Practice Address - Country:US
Practice Address - Phone:503-740-3693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1757175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath