Individual provider · NPI-1

Kaley Anne Bourgeois, N.D.

Naturopath · Tigard, OR

NPI number1487905428
StatusActive
Last updated in NPPESFeb 21, 2022

Details

NPI
1487905428
Entity type
Individual (NPI-1)
Name
Kaley Anne Bourgeois
Credential
N.D.
Sex
Female
Sole proprietor
No
Enumeration date
Oct 1, 2012
Certification date
Feb 21, 2022
Last updated
Feb 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175F00000X Naturopath1896ORYes

Practice location

9735 Sw Shady Ln Ste 303
Tigard, OR 97223-5481

Phone 503-594-7373

Mailing address

9735 Sw Shady Ln Ste 303
Tigard, OR 97223-5481

Phone 503-594-7373

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