Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1420 | OR |
NPI | 1154369593 |
---|---|
Provider Name | Diann Lynn Frease |
First Address | Canby, OR 97013-3533 |
Second Address | Canby, OR 97013-3533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 08/07/2007 |