Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1757 | OR |
NPI | 1013217439 |
---|---|
Provider Name | Dr. Emma Louise Andre |
First Address | Portland, OR 97225-1692 |
Second Address | Portland, OR 97225-1692 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2010 |
Last Update Date | 02/11/2010 |