Individual
IDARA JOHN ETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
139 NE 108TH AVE, PORTLAND, OR 97220-4140
(503) 913-6367
Mailing address
5318 NE 53RD CT, VANCOUVER, WA 98661-7833
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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