MEDICARE: DR. SHANDOR WEISS N.D., L.AC.

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
1	175F00000X	Naturopath	698	OR

General Provider Information

NPI Number	:	1417070616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANDOR WEISS N.D., L.AC.

Provider Business Mailing Address
First Line	:	233 4TH ST
Second Line	:	ARURA CLINIC OF NATURAL MEDICINE
City	:	ASHLAND
State	:	OR
Zip	:	97520-2043
Country	:	US
Telephone Number	:	541-488-1198
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 4TH ST
Second Line	:	ARURA CLINIC OF NATURAL MEDICINE
City	:	ASHLAND
State	:	OR
Zip	:	97520-2043
Country	:	US
Telephone Number	:	541-488-1198
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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