Organization
PEACH SKIN NORTH PORTLAND HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAQUELINE LOPES BROCKERT ND (MANAGER/EMPLOYEE)
(971) 413-3207
Entity
Organization
Contact information
Practice address
3537 N WILLIAMS AVE, PORTLAND, OR 97227-1437
(971) 413-3207
(503) 477-8107
Mailing address
3537 N WILLIAMS AVE, PORTLAND, OR 97227-1437
(971) 413-3207
(503) 477-8107
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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