Provider Demographics
NPI:1144303215
Name:DEL ALBA, LISA KATHLEEN (ND)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:KATHLEEN
Last Name:DEL ALBA
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 1:33476 BLOOMBERG RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-8610
Mailing Address - Country:US
Mailing Address - Phone:541-915-4464
Mailing Address - Fax:541-653-8513
Practice Address - Street 1:33476 BLOOMBERG RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-8610
Practice Address - Country:US
Practice Address - Phone:541-915-4464
Practice Address - Fax:541-653-8513
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1884175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1884OtherOREGON LICENSE
AKN1114OtherBCBS PROVIDER NUMBER