Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | ||
N | 225700000X | Massage Therapist | 7385 | OR |
NPI | 1235202607 |
---|---|
Provider Name | Dr. Pamlin Pegg |
First Address | Portland, OR 97293-0063 |
Second Address | Portland, OR 97205-2629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |