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General NPI Number Information
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NPI Number | 1730349838
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Entity Type | Organization
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Legal Business Name | ART OF MEDICINE FAMILY CLINIC
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 2020 N MCCLELLAN ST
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City | PORTLAND
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State | OR
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Zip | 97217-6824
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Country | US
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Telephone | 503-408-9000
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Fax | 503-249-3774
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Provider Business Mailing Address
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Address Line | 2020 N MCCLELLAN ST
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City | PORTLAND
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State | OR
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Zip | 97217-6824
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Country | US
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Telephone | 503-408-9000
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Fax | 503-249-3774
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Authorized Official
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Title or Position | OWNER/ NATUROPATHIC DOCTOR
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Name | DR. EVELYN CUSSON
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Credential | ND
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Telephone | 503-408-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 1243
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License Number State | OR
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