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Individual

EMILY SIMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1842 NW 25TH AVE STE A, PORTLAND, OR 97210-2568
(503) 206-9087
Mailing address
1842 NW 25TH AVE STE A, PORTLAND, OR 97210-2568
(503) 206-9087

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18634
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1255683231
LMT
OR
Enumeration date
10/15/2012
Last updated
04/23/2019
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