Provider Demographics
NPI:1124424197
Name:PDX NATURAL MEDICINE
Entity type:Organization
Organization Name:PDX NATURAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ONYRIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSCHUDY
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:520-409-2851
Mailing Address - Street 1:19255 SW 65TH AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9717
Mailing Address - Country:US
Mailing Address - Phone:520-409-2851
Mailing Address - Fax:503-296-2794
Practice Address - Street 1:19255 SW 65TH AVE STE 220
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9717
Practice Address - Country:US
Practice Address - Phone:520-409-2851
Practice Address - Fax:503-296-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2030175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty