Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1174882104 |
---|---|
Provider Name | Raquael Flores-Vuylsteke |
First Address | Sunriver, OR 97707-1676 |
Second Address | Sunriver, OR 97707-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2012 |
Last Update Date | 26/11/2013 |