Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 931 | OR |
NPI | 1043388119 |
---|---|
Provider Name | Dr. Kathleen Renee Flewelling |
First Address | Seaside, OR 97138-6802 |
Second Address | Seaside, OR 97138-6802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 08/07/2007 |