Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 28-1437 | OR |
Y | 175F00000X | Naturopath | 0848 | OR |
NPI | 1619116001 |
---|---|
Provider Name | Dr. Cathryn Luanne Selchow |
First Address | Portland, OR 97225-5105 |
Second Address | Portland, OR 97225-5105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2009 |
Last Update Date | 07/11/2018 |