Provider Demographics
NPI:1043653074
Name:PEDRO, SANGITAPRIYA (ND)
Entity type:Individual
Prefix:
First Name:SANGITAPRIYA
Middle Name:
Last Name:PEDRO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3439 NE SANDY BLVD # 359
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1959
Mailing Address - Country:US
Mailing Address - Phone:207-274-2111
Mailing Address - Fax:207-221-1095
Practice Address - Street 1:655 REDWOOD HWY FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3034
Practice Address - Country:US
Practice Address - Phone:415-569-4470
Practice Address - Fax:844-787-4719
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1426175F00000X
CAND1075175F00000X
MENP505175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty