Provider Demographics
NPI:1831496876
Name:DIAZ, RAYMOND HOWLORN (ND)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:HOWLORN
Last Name:DIAZ
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 NE 12TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2752
Mailing Address - Country:US
Mailing Address - Phone:503-231-0424
Mailing Address - Fax:503-293-6381
Practice Address - Street 1:407 NE 12TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2752
Practice Address - Country:US
Practice Address - Phone:503-231-0424
Practice Address - Fax:503-293-6381
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR580175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath