Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1884 | OR |
NPI | 1144303215 |
---|---|
Provider Name | Dr. Lisa Kathleen Del Alba |
First Address | Eugene, OR 97405-8610 |
Second Address | Eugene, OR 97405-8610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 14/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1884 | OREGON LICENSE (01) | OR |
N1114 | BCBS PROVIDER NUMBER (01) | AK |