Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | OR |
NPI | 1003325804 |
---|---|
Provider Name | Dr. Elliot Trustin Taxman |
First Address | Portland, OR 97201-4704 |
Second Address | Portland, OR 97201-4858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2017 |
Last Update Date | 25/09/2017 |