Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 2042 | OR |
NPI | 1073916185 |
---|---|
Provider Name | Dr. Stephanie Dentinger-Doo Culver |
First Address | Tualatin, OR 97062-6323 |
Second Address | Tigard, OR 97224-7913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 18/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2042 | OREGON BOARD OF NATUROPATHIC MEDICINE (01) | OR |
MC2582536 | DEA (01) |