Provider Demographics
NPI:1871375097
Name:VADIPOUR, SHEYDA (NMD)
Entity type:Individual
Prefix:
First Name:SHEYDA
Middle Name:
Last Name:VADIPOUR
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8413 E CHAPARRAL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7447
Mailing Address - Country:US
Mailing Address - Phone:480-370-0899
Mailing Address - Fax:
Practice Address - Street 1:9855 S PRIEST DR STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3605
Practice Address - Country:US
Practice Address - Phone:480-712-7499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ23-1816175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath