Healthcare Provider Details

I. General information

NPI: 1407173024
Provider Name (Legal Business Name): NATHAN SCHULMAN L.AC,OMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 JEFFERSON ST
EUGENE OR
97402-5223
US

IV. Provider business mailing address

850 JEFFERSON ST
EUGENE OR
97402-5223
US

V. Phone/Fax

Practice location:
  • Phone: 541-687-6645
  • Fax:
Mailing address:
  • Phone: 541-687-6645
  • Fax: 541-687-6645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01114
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC3139
License Number StateCA

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: