Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 4284 | OR |
NPI | 1134761638 |
---|---|
Provider Name | Elizabeth Sandell |
First Address | Tigard, OR 97223-9634 |
Second Address | Tigard, OR 97223-9634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2019 |
Last Update Date | 16/10/2019 |