Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 873 | OR |
Y | 175F00000X | Naturopath | NT00001106 | WA |
NPI | 1023057635 |
---|---|
Provider Name | Dr. Maureen Elizabeth O'connor |
First Address | Vancouver, WA 98684-5871 |
Second Address | Vancouver, WA 98684-5871 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 10/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
112784 | KAISER PERMANENTE PROV ID (01) | OR |