Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 4291 | OR |
NPI | 1063055630 |
---|---|
Provider Name | Dr. Sean Peter Horan |
First Address | Portland, OR 97214-3819 |
Second Address | Portland, OR 97214-3819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2019 |
Last Update Date | 03/04/2020 |