1073997466 NPI number — MS. NATASHA CHELLE DELFIORENTINO LMT

Table of content: MS. NATASHA CHELLE DELFIORENTINO LMT (NPI 1073997466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073997466 NPI number — MS. NATASHA CHELLE DELFIORENTINO LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELFIORENTINO
Provider First Name:
NATASHA
Provider Middle Name:
CHELLE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
APATHY
Provider Other First Name:
NATASHA
Provider Other Middle Name:
CHELLE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1073997466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1841
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-903-1288
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1470 NE 1ST ST.
Provider Second Line Business Practice Location Address:
STE #200
Provider Business Practice Location Address City Name:
BEND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-903-1288
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2015

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: 225700000X , with the licence number:  20032 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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