Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | 404426 | OR |
NPI | 1225198971 |
---|---|
Provider Name | Anna Morrow |
First Address | Portland, OR 97290-6364 |
Second Address | Portland, OR 97206-7348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |