1245272863 NPI number — DR. DEIRDRE ORCEYRE N.D., MSOM, LAC

Table of content: DR. DEIRDRE ORCEYRE N.D., MSOM, LAC (NPI 1245272863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245272863 NPI number — DR. DEIRDRE ORCEYRE N.D., MSOM, LAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORCEYRE
Provider First Name:
DEIRDRE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
N.D., MSOM, LAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245272863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
908 NEW HAMPSHIRE AVE NW
Provider Second Line Business Mailing Address:
GW CENTER FOR INTEGRATIVE MEDICINE SUITE 200
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20037-2346
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-833-5055
Provider Business Mailing Address Fax Number:
202-833-5755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
908 NEW HAMPSHIRE AVE NW
Provider Second Line Business Practice Location Address:
GW CENTER FOR INTEGRATIVE MEDICINE SUITE 200
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20037-2346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-833-5055
Provider Business Practice Location Address Fax Number:
202-833-5755
Provider Enumeration Date:
06/11/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC00859 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175F00000X , with the licence number: 1357 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 171100000X , with the licence number: AC500078 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175F00000X , with the licence number: NP-0003 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)