Provider Demographics
NPI:1679032502
Name:RICH, NATALIE LAINE (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:LAINE
Last Name:RICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 745249
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-5249
Mailing Address - Country:US
Mailing Address - Phone:800-475-3698
Mailing Address - Fax:706-653-1162
Practice Address - Street 1:777 NW 9TH ST STE 210C
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6169
Practice Address - Country:US
Practice Address - Phone:800-475-3698
Practice Address - Fax:706-653-1162
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD2238632085R0202X
WAMD615238672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology