Provider Demographics
NPI:1649321670
Name:MARTIN-BELLEVILLE, DEBRA LOUISE (ND)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LOUISE
Last Name:MARTIN-BELLEVILLE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 COUNTRY CLUB RD STE270
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6046
Mailing Address - Country:US
Mailing Address - Phone:541-683-4071
Mailing Address - Fax:541-687-1952
Practice Address - Street 1:911 COUNTRY CLUB RD STE 270
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6046
Practice Address - Country:US
Practice Address - Phone:541-683-4071
Practice Address - Fax:541-687-1952
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR554175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR554OtherLICENCE IN OREGON AS A ND