Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 1248R | OR |
N | 175F00000X | Naturopath | NT00001395 | WA |
NPI | 1043229248 |
---|---|
Provider Name | Dr. Pat A Buckley |
First Address | Portland, OR 97209-3514 |
Second Address | Portland, OR 97209-3514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 22/09/2010 |