Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 3018 | OR |
NPI | 1114397213 |
---|---|
Provider Name | Trisha Lee |
First Address | Portland, OR 97212-2218 |
Second Address | Portland, OR 97212-2218 |
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 |