Patient Guide
What is a Naturopathic Doctor?
A naturopathic doctor (ND) is a licensed primary care provider trained in both conventional medical science and evidence-based natural therapies. Here's what that means in practice.
The short answer
A licensed naturopathic doctor — sometimes abbreviated ND or NMD — is a primary care physician who completes a four-year, in-residence doctoral program at an accredited naturopathic medical school. NDs are trained in the same biomedical sciences as MDs and DOs (anatomy, physiology, pharmacology, pathology, clinical diagnosis, and so on), with additional clinical training in nutrition, botanical medicine, lifestyle counseling, and mind-body medicine. In licensed states, NDs can order labs, prescribe medications, and refer to specialists.
What does an ND actually do?
A typical day for an ND looks a lot like a typical day for any primary care doctor — annual wellness visits, managing chronic conditions, ordering labs, interpreting imaging, writing prescriptions, and coordinating care with specialists. The difference is the additional tools in the toolkit:
- Conventional primary care — lab work, physicals, prescriptions, chronic disease management, referrals.
- Clinical nutrition — targeted dietary interventions for conditions like IBS, insulin resistance, hormone imbalance, or autoimmunity.
- Botanical medicine — evidence-based use of plant compounds for sleep, anxiety, digestion, infections, and more.
- Lifestyle medicine — sleep, stress, movement, environment — the levers that conventional 15-minute visits rarely have time to pull.
How are naturopathic doctors trained?
Licensed NDs complete a four-year, in-residence Doctor of Naturopathic Medicine (ND or NMD) program at one of seven schools accredited by the Council on Naturopathic Medical Education (CNME) — the U.S. Department of Education-recognized accreditor for the profession. Programs include:
Two years of biomedical sciences
Anatomy, physiology, biochemistry, microbiology, pathology, pharmacology — the same foundational coursework as MD/DO programs.
Two years of clinical training
Differential diagnosis, physical exam, lab and imaging interpretation, pharmacology, plus naturopathic modalities (clinical nutrition, botanical medicine, hydrotherapy, counseling).
Board licensing exams (NPLEX)
All NDs must pass the Naturopathic Physicians Licensing Examinations — a basic-sciences part after year two and a clinical part after graduation.
Many graduates also complete an optional one- or two-year residency in primary care, women's health, or another focus.
ND vs. MD vs. “traditional naturopath”
One of the most common sources of confusion: not every “naturopath” is a licensed ND. The differences matter for both safety and scope.
Licensed ND
Four-year accredited doctoral program. Board-licensed. Acts as a primary care physician in licensed states.
MD / DO
Conventional medical or osteopathic doctor. Four years of medical school plus residency. Standard primary or specialty care.
“Traditional naturopath”
Not a licensed medical provider. Often a correspondence-style certificate. Cannot diagnose, prescribe, or order labs.
Where are NDs licensed?
NDs are licensed as medical providers in about half of U.S. states plus Washington, D.C. and several territories. Mary Harel is licensed in:
- Oregon — NDs are recognized as primary care providers with full prescriptive authority.
- Washington — NDs are licensed primary care providers and are required to be covered by health insurance plans regulated by the state.
What can an ND prescribe and order?
In Oregon and Washington, licensed NDs can:
- Order and interpret blood work, imaging, and specialty labs
- Write prescriptions for most medications (including most controlled substances in OR)
- Diagnose medical conditions
- Refer to specialists and coordinate care with your other providers
- Provide annual wellness exams, women's health exams, and acute care
Is naturopathic care covered by insurance?
Coverage varies by state and plan. In Washington, most health plans are required by state law to cover services from licensed NDs. In Oregon, many plans cover ND visits but specifics vary by carrier. At Cove Naturopathic we operate on a self-pay model and provide a superbill for out-of-network reimbursement; HSA and FSA accounts are accepted.
Considering working with a naturopathic doctor?
Dr. Mary Harel offers naturopathic primary care via telemedicine to patients in Oregon and Washington. Your first visit is a 75-minute consultation.
See also: Frequently asked questions · What we treat · What to expect at your first visit