Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1204 | OR |
NPI | 1124168844 |
---|---|
Provider Name | Dr. Ami K Opal |
First Address | Portland, OR 97214-2276 |
Second Address | Portland, OR 97214-2276 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 29/09/2016 |