Provider Demographics
NPI:1104955871
Name:CHANDLER, LOCH STEPHEN (ND, MSOM, LAC)
Entity type:Individual
Prefix:DR
First Name:LOCH
Middle Name:STEPHEN
Last Name:CHANDLER
Suffix:
Gender:M
Credentials:ND, MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 NE GLISAN ST STE 300A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3052
Mailing Address - Country:US
Mailing Address - Phone:503-215-3219
Mailing Address - Fax:503-215-7572
Practice Address - Street 1:5251 NE GLISAN ST STE 300A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3052
Practice Address - Country:US
Practice Address - Phone:503-215-3219
Practice Address - Fax:503-215-7572
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00590171100000X
OR1116175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175F00000XOther Service ProvidersNaturopath