Individual provider Active NPI

Derek Justin Andre, N.D.

  • Naturopath
  • Portland, OR
National Provider Identifier
1922436450
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1996 Issued in 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
Last updated
Oct 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 1996 OR Primary

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

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
1996ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1922436450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 SW SCHOLLS FERRY RD STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251692",
            "telephone_number": "503-567-8234",
            "fax_number": "888-789-6343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 SW SCHOLLS FERRY RD STE 202",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972251692",
            "telephone_number": "503-567-8234",
            "fax_number": "888-789-6343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRE",
        "first_name": "DEREK",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "N.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-18",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.