Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 3068 | OR |
NPI | 1144686379 |
---|---|
Provider Name | Dr. Laura Neville |
First Address | Portland, OR 97206-8240 |
Second Address | Portland, OR 97219-2096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2016 |
Last Update Date | 04/01/2016 |