Individual
ELI CLOVER CUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 SE LAFAYETTE ST STE 100, PORTLAND, OR 97202-3802
(503) 765-5733
Mailing address
1515 N AINSWORTH ST APT 66, PORTLAND, OR 97217-4776
(503) 475-6940
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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