Provider Demographics
NPI:1366221590
Name:REX, MAGGIE ELIZABETH (ND)
Entity type:Individual
Prefix:DR
First Name:MAGGIE
Middle Name:ELIZABETH
Last Name:REX
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 1:701 N 5TH ST UNIT B1010
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-0087
Mailing Address - Country:US
Mailing Address - Phone:503-509-9342
Mailing Address - Fax:
Practice Address - Street 1:701 N 5TH ST UNIT B1010
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-0087
Practice Address - Country:US
Practice Address - Phone:503-509-9342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5015175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath