Derek Justin Andre, N.D.
Individual provider Active NPI Naturopath · Portland, OR
NPI 1922436450 · NPPES record last updated Oct 18, 2013
Key facts
- NPI
- 1922436450
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 1996 (OR)
- Practice address
- 4850 SW Scholls Ferry Rd Ste 202
Portland, OR 97225-1692 - Phone
- (503) 567-8234
- Fax
- (888) 789-6343
- NPI assigned
- Oct 18, 2013
- Sex
- Male
- 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 |
|---|---|---|---|
| 1996 | OR | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1996 | OR | Yes |
Addresses
Primary practice location
4850 SW Scholls Ferry Rd Ste 202
Portland, OR 97225-1692
Mailing address
4850 SW Scholls Ferry Rd Ste 202
Portland, OR 97225-1692
Phone (503) 567-8234
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 Oct 18, 2013. 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.