Individual
NICOLE GANSEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
2612 E BARNETT RD, MEDFORD, OR 97504-8344
(541) 770-5563
Mailing address
1836 NE 7TH AVE STE 206, PORTLAND, OR 97212-3998
(503) 282-1070
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
—
OR
Other
Enumeration date
07/30/2019
Last updated
12/21/2020
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