Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 0779 | OR |
NPI | 1073657912 |
---|---|
Provider Name | Ms. Elizabeth A. Laurenson |
First Address | Albany, OR 97321-1789 |
Second Address | Albany, OR 97321-1789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 03/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065891 | (05) | OR |