Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | ND-547 | CA |
N | 175F00000X | Naturopath | NT60451628 | WA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 202107432NP-PP | OR |
NPI | 1053663757 |
---|---|
Provider Name | Satish Chintamani Mohan |
First Address | The Dalles, OR 97058-9403 |
Second Address | The Dalles, OR 97058-9403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2012 |
Last Update Date | 27/07/2021 |