Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | OR |
NPI | 1063796530 |
---|---|
Provider Name | Dr. Jessica Brooke Huffman |
First Address | Portland, OR 97209-3907 |
Second Address | Portland, OR 97209-3907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2011 |
Last Update Date | 28/08/2014 |