Healthcare Provider Details

I. General information

NPI: 1811608490
Provider Name (Legal Business Name): MALGORZATA PTAK ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET PTAK ND

II. Dates (important events)

Enumeration Date: 12/06/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N COLUMBIA RIVER HWY
SAINT HELENS OR
97051-1226
US

IV. Provider business mailing address

8503 SE 57TH AVE UNIT B
PORTLAND OR
97206-0893
US

V. Phone/Fax

Practice location:
  • Phone: 503-410-3134
  • Fax: 503-893-3118
Mailing address:
  • Phone: 917-399-7063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4485
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC211757
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: