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NPI Code Detail

MEDICARE: LACROUTE NATURAL MEDICINE, INC.

MEDICARE: LACROUTE NATURAL MEDICINE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistAC150508OR
2175F00000XNaturopath1334OR

General Provider Information

NPI Number : 1184912560
Entity Type Code : Organization
Provider Name (Legal Business Name) : LACROUTE NATURAL MEDICINE, INC.
Provider Business Mailing Address
First Line : 505 NW 9TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97209-3578
Country : US
Telephone Number : 503-477-4399
Fax Number : 503-477-9197
Provider Business Practice Location Address
First Line : 505 NW 9TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97209-3578
Country : US
Telephone Number : 503-477-4399
Fax Number : 503-477-9197
Authorized Official
Title or Position : PRESIDENT
Name : DR. NATHALIE LACROUTE
Credential : N.D.
Telephone Number : 503-477-4399
Provider Enumeration Date : 07/19/2011
Last Update Date : 07/19/2011

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Directions to “LACROUTE NATURAL MEDICINE, INC. ” Practice Location

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