Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1093376022 |
---|---|
Provider Name | Angela Hardin |
First Address | Portland, OR 97211-5882 |
Second Address | Portland, OR 97201-4858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2019 |
Last Update Date | 20/06/2019 |