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NPI Code Detail

MEDICARE: FREDERICA JANE SPRING L.M.T. DOULA

MEDICARE: FREDERICA JANE SPRING L.M.T. DOULA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1942647334
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICA JANE SPRING L.M.T. DOULA
Provider Business Mailing Address
First Line : 7225 N GREELEY AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97217-5241
Country : US
Telephone Number : 319-572-3686
Fax Number :
Provider Business Practice Location Address
First Line : 7225 N GREELEY AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97217-5241
Country : US
Telephone Number : 319-572-3686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2013
Last Update Date : 05/27/2013

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