Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1680 | OR |
NPI | 1093862112 |
---|---|
Provider Name | Dr. Jeffrey Kiker |
First Address | Portland, OR 97206-8969 |
Second Address | Portland, OR 97239-4389 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 01/03/2010 |