Individual
KOALI ANYA BLUMER-BUELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
6355 N HAIGHT AVE, PORTLAND, OR 97217-2121
(503) 888-7346
Mailing address
6355 N HAIGHT AVE, PORTLAND, OR 97217-2121
(503) 888-7346
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
LC-LC-10220125
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LC-LC-10220125
OREGON HEALTH LICENSING
OR
Enumeration date
03/07/2022
Last updated
03/07/2022
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