Provider Demographics
NPI:1336221829
Name:MARCUS, RHONDA R (ND, LLC)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:R
Last Name:MARCUS
Suffix:
Gender:F
Credentials:ND, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 86130
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97286-0130
Mailing Address - Country:US
Mailing Address - Phone:503-282-5725
Mailing Address - Fax:503-231-6658
Practice Address - Street 1:5139 SE IVON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206
Practice Address - Country:US
Practice Address - Phone:503-282-5725
Practice Address - Fax:503-231-6658
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1095175F00000X, 175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath