Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 2030 | OR |
N | 176B00000X | Midwife | 13010006 | OR |
N | 176B00000X | Midwife | LM149 | AZ |
NPI | 1013154053 |
---|---|
Provider Name | Mrs. Onyria Gillmor |
First Address | Portland, OR 97214-5898 |
Second Address | Tualatin, OR 97062-9196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2009 |
Last Update Date | 13/02/2020 |