Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1374 | OR |
NPI | 1013051671 |
---|---|
Provider Name | Wendy Denise Vannoy |
First Address | Portland, OR 97210-5352 |
Second Address | Portland, OR 97210-5352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2007 |
Last Update Date | 18/11/2021 |