Provider Demographics
NPI:1154964476
Name:THURMAN, REBECCA JO (ND)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JO
Last Name:THURMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:JO
Other - Last Name:BOATMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2519 NW NORWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-9023
Mailing Address - Country:US
Mailing Address - Phone:573-268-8068
Mailing Address - Fax:
Practice Address - Street 1:3606 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2235
Practice Address - Country:US
Practice Address - Phone:360-823-8121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT61003600175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath