Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 273184 | OR |
NPI | 1710004932 |
---|---|
Provider Name | Dr. Betsy J Mitchell |
First Address | Portland, OR 97202-3835 |
Second Address | Portland, OR 97202-3835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |