Provider Demographics
NPI:1316084437
Name:KARLI, AZURE (ND)
Entity type:Individual
Prefix:
First Name:AZURE
Middle Name:
Last Name:KARLI
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 1:715 NW HILL ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2922
Mailing Address - Country:US
Mailing Address - Phone:541-389-9750
Mailing Address - Fax:541-389-2250
Practice Address - Street 1:715 NW HILL ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2922
Practice Address - Country:US
Practice Address - Phone:541-389-9750
Practice Address - Fax:541-389-2250
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1294175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath