Individual
ALICE LEEYONGE CAPITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
316 NE 28TH AVE, PORTLAND, OR 97232-3150
(503) 230-0812
(503) 233-9151
Mailing address
316 NE 28TH AVE, PORTLAND, OR 97232-3150
(503) 230-0812
(503) 233-9151
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27-3251
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140931
MEDICARE GROUP PIN
OR
Enumeration date
11/28/2006
Last updated
01/12/2010
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