Healthcare Provider Details

I. General information

NPI: 1467534545
Provider Name (Legal Business Name): HOWARD J. REINGOLD N.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

497 SW CENTURY DR. SUITE 120
BEND OR
97702-4628
US

IV. Provider business mailing address

497 SW CENTURY DR STE 120
BEND OR
97702-1167
US

V. Phone/Fax

Practice location:
  • Phone: 541-389-6935
  • Fax: 541-388-4966
Mailing address:
  • Phone: 541-389-6935
  • Fax: 541-388-4966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number0608
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: