Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 27 2908 | OR |
NPI | 1659598480 |
---|---|
Provider Name | Catherine Cummins |
First Address | Portland, OR 97215-3112 |
Second Address | Portland, OR 97215-3112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |