Individual
ALIA APPOLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 SW WASHINGTON, PORTLAND, OR 97205
(503) 535-1151
Mailing address
PO BOX 3007, PORTLAND, OR 97208-3007
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
7482440
OR
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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