Healthcare Provider Details

I. General information

NPI: 1265955108
Provider Name (Legal Business Name): DISCOVERY HEALTHCARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2017
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4175 E AMAZON DR
EUGENE OR
97405-4660
US

IV. Provider business mailing address

4175 E AMAZON DR
EUGENE OR
97405-4660
US

V. Phone/Fax

Practice location:
  • Phone: 541-338-9494
  • Fax: 541-338-8496
Mailing address:
  • Phone: 541-338-9494
  • Fax: 541-338-8496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1552
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier1578786083
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: DR. MICHELLE NIESLEY
Title or Position: OWNER / NATUROPATHIC DOCTOR
Credential: ND
Phone: 541-338-9494