Provider Demographics
NPI:1184803926
Name:KASSAM, NATASHA (ND)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:KASSAM
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 1:1275 SW CARDINELL DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-3114
Mailing Address - Country:US
Mailing Address - Phone:503-966-0132
Mailing Address - Fax:503-386-3375
Practice Address - Street 1:2512 SE 25TH AVE STE 202D
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-2075
Practice Address - Country:US
Practice Address - Phone:503-966-0132
Practice Address - Fax:503-386-3375
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1563175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1563OtherOBNE