Provider Demographics
NPI:1912280942
Name:ANDERSON, DEBORAH ELIZABETH (ND)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:ANDERSON
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 1:5060 SW PHILOMATH BLVD #336
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333
Mailing Address - Country:US
Mailing Address - Phone:541-929-3877
Mailing Address - Fax:541-230-9166
Practice Address - Street 1:5060 SW PHILOMATH BLVD #336
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333
Practice Address - Country:US
Practice Address - Phone:541-929-3877
Practice Address - Fax:541-230-9166
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2022-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1357175F00000X
OR1834175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1357OtherCALIFORNIA NATUROPATHIC DOCTOR LICENSE