Healthcare Provider Details

I. General information

NPI: 1205342284
Provider Name (Legal Business Name): LADAISY E TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2017
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 SE 52ND AVE STE B
PORTLAND OR
97206-3913
US

IV. Provider business mailing address

1580 NE 32ND AVE APT 434
PORTLAND OR
97232-3559
US

V. Phone/Fax

Practice location:
  • Phone: 971-229-2140
  • Fax: 971-233-6416
Mailing address:
  • Phone: 305-298-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number5158
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: