Healthcare Provider Details

I. General information

NPI: 1073988960
Provider Name (Legal Business Name): CARLY POLLAND ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2015
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 S 2ND ST UNIT 62
INDEPENDENCE OR
97351-2077
US

IV. Provider business mailing address

216 S 2ND ST UNIT 62
INDEPENDENCE OR
97351-2077
US

V. Phone/Fax

Practice location:
  • Phone: 916-907-1779
  • Fax:
Mailing address:
  • Phone: 916-917-1779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND764
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number5123
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number61077803
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: