Healthcare Provider Details

I. General information

NPI: 1548819923
Provider Name (Legal Business Name): OCTAVIAN NATURAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2019
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2995 BASELINE RD STE 204
BOULDER CO
80303-2318
US

IV. Provider business mailing address

2995 BASELINE RD STE 204
BOULDER CO
80303-2318
US

V. Phone/Fax

Practice location:
  • Phone: 720-213-6776
  • Fax:
Mailing address:
  • Phone: 720-213-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRIS MATTHEW PALISZEWSKI
Title or Position: OWNER
Credential: ND, LMT
Phone: 720-213-6776