Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1947 | OR |
NPI | 1053658609 |
---|---|
Provider Name | Dr. Amity Rose Vacarella |
First Address | Portland, OR 97203-4464 |
Second Address | Portland, OR 97203-4464 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2013 |
Last Update Date | 15/01/2013 |