Provider Demographics
NPI:1295870012
Name:EDMISTEN, KAREN ELIZABETH (ND, LAC)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELIZABETH
Last Name:EDMISTEN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 SW 7TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-4915
Mailing Address - Country:US
Mailing Address - Phone:541-265-6378
Mailing Address - Fax:541-265-6378
Practice Address - Street 1:344 SW 7TH ST STE B
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4915
Practice Address - Country:US
Practice Address - Phone:541-265-6378
Practice Address - Fax:541-265-6378
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR 733175F00000X
ORAC00187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist