Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 3040 | OR |
NPI | 1023488178 |
---|---|
Provider Name | Sabra Marie Royer |
First Address | Portland, OR 97201-4858 |
Second Address | Portland, OR 97201-4858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2015 |
Last Update Date | 01/10/2015 |