Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | K9984 | TX |
NPI | 1316027683 |
---|---|
Provider Name | Paula Amato |
First Address | Portland, OR 97239-4501 |
Second Address | Portland, OR 97239-4501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 12/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117043303 | (05) | TX |
G37243 | (02) |