Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 693 | OR |
NPI | 1073627402 |
---|---|
Provider Name | Dr. Gregory Paul Garcia |
First Address | Portland, OR 97211-2519 |
Second Address | Beaverton, OR 97005-0546 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 12/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008099 | (05) | OR |