Healthcare Provider Details

I. General information

NPI: 1568535128
Provider Name (Legal Business Name): DAVID A. BOVE N.D., L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 E 18TH AVE
EUGENE OR
97401-4360
US

IV. Provider business mailing address

695 WALNUT AVE
EUGENE OR
97404-3174
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-9658
  • Fax: 877-852-8025
Mailing address:
  • Phone: 541-688-9988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1176
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number559
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1176
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier#227955
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerOMAP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: