Provider Demographics
NPI:1245544857
Name:BALDWIN, CHANTELLE MARIE (DO, ND)
Entity type:Individual
Prefix:DR
First Name:CHANTELLE
Middle Name:MARIE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:DO, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 COBURG RD STE 1
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5200
Mailing Address - Country:US
Mailing Address - Phone:541-799-0070
Mailing Address - Fax:
Practice Address - Street 1:1310 COBURG RD STE 1
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5200
Practice Address - Country:US
Practice Address - Phone:541-799-0070
Practice Address - Fax:541-799-0078
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4069175F00000X
OR261Q00000X
WAOP60751263208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No175F00000XOther Service ProvidersNaturopath
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center