Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 656619 | OR |
NPI | 1093013161 |
---|---|
Provider Name | Holly Rae St.lawrence |
First Address | Eugene, OR 97404-2961 |
Second Address | Eugene, OR 97404-2961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2011 |
Last Update Date | 14/03/2011 |