Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 0627 | OR |
N | 175L00000X | Homeopath | 0627 | OR |
NPI | 1265505200 |
---|---|
Provider Name | Dr. Mary F Caselli |
First Address | Portland, OR 97212-4722 |
Second Address | Portland, OR 97232-3150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |