Peabody, Judy E

Peabody, Judy E is an sole proprietor health care provider with primary practice located at 4085 Sw 109Th Ave Ste 200 , Beaverton OR 97005-3000. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Naturopath, Other Service Providers / Homeopath. Other Service Providers / Naturopath is her primary health care specialty. Peabody, Judy E can be contacted via phone (503) 643-1024.

Contact Information

Primary practice address
4085 Sw 109Th Ave Ste 200 Beaverton OR 97005-3000
Phone: (503) 643-1024
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X 704 Oregon
Other Service Providers / Homeopath 175L00000X 704 Oregon

Profile Details

NPI number 1164593638
LBN Legal business name Peabody, Judy E
Credentials N.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164593638 NPPES
Oregon Other 022553 OREGON MEDICAL ASSISTANCE

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