Provider Demographics
NPI:1770748238
Name:GIUDICI, KORI LEE (ND)
Entity type:Individual
Prefix:DR
First Name:KORI
Middle Name:LEE
Last Name:GIUDICI
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 1:135 NE 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3709
Mailing Address - Country:US
Mailing Address - Phone:503-819-5575
Mailing Address - Fax:
Practice Address - Street 1:135 NE 57TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3709
Practice Address - Country:US
Practice Address - Phone:503-819-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1554175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath