Individual
DR. CORY SEAN TICHAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ND
Contact information
Practice address
1012 E JACKSON ST, MEDFORD, OR 97504-7027
(541) 770-5563
(541) 772-3028
Mailing address
1012 E JACKSON ST, MEDFORD, OR 97504-7027
(541) 770-5563
(541) 772-3028
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
1324
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
029098
—
OR
01
—
865304002
BLUE CROSS BLUE SHIELD
OR
Enumeration date
12/06/2006
Last updated
08/05/2009
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