Individual provider Active NPI

Carolyn Iacullo Nygaard, N.D

  • Naturopath
  • Astoria, OR
National Provider Identifier
1649500646
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1717 Issued in OR
Practice address
757 W Marine Dr Ste 103
Astoria, OR 97103-5848
Phone
(207) 209-4858
Fax
(207) 405-2199
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X NATU.NT.61208539 WA
Naturopath 175F00000X ND1546 CA
Naturopath 175F00000X 1717 OR Primary
Naturopath 175F00000X NP839 ME

Addresses

Primary practice location

757 W Marine Dr Ste 103
Astoria, OR 97103-5848

Mailing address

757 W Marine Dr Ste 103
Astoria, OR 97103-5848
Phone (207) 209-4858

Other practice location 1

254 Commercial St Ste 258
Portland, ME 04101-4664
Phone (207) 209-4858

Other identifiers 1

IdentifierTypeStateIssuer
500642404MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address info@naturopathicbydesign.com Health Information Exchange (HIE)
Direct Messaging Address info@naturopathicbydesign.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND1546CAMDNaturopath
NP839MEMDNaturopath
1717ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Earth Source Medicine Current Accepting new patients
Astoria Birth Center Providers Naturopath Past Accepting new patients

Locations

254 Commercial St
Ste 258
Portland, ME 04101
Phone (207) 209-4858

757 W Marine Dr
Ste 103
Astoria, OR 97103
Phone (207) 209-4858

1490 Commercial St
Ste 200
Astoria, OR 97103
Phone (503) 325-8222

2207 NE Broadway St
Ste 200
Portland, OR 97232
Phone (503) 236-6006

Interoperability endpoints

  • Direct secure messaging: astoriabirthcenter.carolynnygaard@146665.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1649500646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 W MARINE DR STE 103",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971035848",
            "telephone_number": "207-209-4858",
            "fax_number": "207-405-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 W MARINE DR STE 103",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971035848",
            "telephone_number": "207-209-4858",
            "fax_number": "207-405-2199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "254 Commercial St Ste 258",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041014664",
            "country_code": "US",
            "telephone_number": "207-209-4858",
            "fax_number": "207-405-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYGAARD",
        "first_name": "CAROLYN",
        "middle_name": "IACULLO",
        "name_prefix": "Dr.",
        "credential": "N.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NATU.NT.61208539",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "ND1546",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1717",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "ME",
            "license": "NP839",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500642404",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@naturopathicbydesign.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "757 W Marine Dr Ste 103",
            "city": "Astoria",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971035848",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@naturopathicbydesign.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "254 Commercial St Ste 258",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041014664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.