Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 2036 | OR |
NPI | 1073917142 |
---|---|
Provider Name | Dr. Sara Elaine Defrancesco |
First Address | Portland, OR 97212-2356 |
Second Address | Portland, OR 97232-3094 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2014 |
Last Update Date | 09/04/2015 |