Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-164398 | OR |
NPI | 1124651518 |
---|---|
Provider Name | Robin Nunez |
First Address | Beaverton, OR 97007-4611 |
Second Address | Beaverton, OR 97007-4611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2020 |
Last Update Date | 13/02/2020 |