Marina Vladimirovna Bazyuk, ND
Individual provider Active NPI Naturopath · Portland, OR
NPI 1447572839 · NPPES record last updated Sep 6, 2012
Key facts
- NPI
- 1447572839
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 1722 (OR)
- Practice address
- 8375 SW Beaverton Hillsdale Hwy
Suite B
Portland, OR 97225 - Phone
- (503) 770-0292
- NPI assigned
- Feb 25, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1722 | OR | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1722 | OR | Yes |
Addresses
Primary practice location
8375 SW Beaverton Hillsdale Hwy
Suite B
Portland, OR 97225
Mailing address
1061 SE Tamango St
Hillsboro, OR 97123-4689
Phone (503) 210-5489
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.