Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | OR ND 0879 | OR |
NPI | 1023231222 |
---|---|
Provider Name | Dr. Regina Ida Dehen |
First Address | Portland, OR 97201-4858 |
Second Address | Portland, OR 97201-4858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 14/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138243 | (05) | OR |