Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 4039 | OR |
NPI | 1134499965 |
---|---|
Provider Name | Dr. Samantha Evelyne Evans Rayack |
First Address | Eugene, OR 97401-4603 |
Second Address | Eugene, OR 97401-4603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 04/04/2017 |