Provider Demographics
NPI:1861219693
Name:RUBENS, MOLLY FAYE (ND)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:FAYE
Last Name:RUBENS
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 1:990 BROADWAY ST NE APT 306
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-1396
Mailing Address - Country:US
Mailing Address - Phone:509-990-3504
Mailing Address - Fax:
Practice Address - Street 1:960 LIBERTY ST SE STE 210
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4195
Practice Address - Country:US
Practice Address - Phone:503-334-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5058175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath