Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 4030 | OR |
NPI | 1093265530 |
---|---|
Provider Name | Katherine Eleni Hampilos |
First Address | Portland, OR 97211-3523 |
Second Address | Portland, OR 97201-4848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2016 |
Last Update Date | 08/10/2016 |