Provider Demographics
NPI:1093595217
Name:COHN, AMELIA R (ND)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:R
Last Name:COHN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 N INTERSTATE AVE APT 519
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-3794
Mailing Address - Country:US
Mailing Address - Phone:541-588-0133
Mailing Address - Fax:
Practice Address - Street 1:30485 SW BOONES FERRY RD STE 104
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-7845
Practice Address - Country:US
Practice Address - Phone:503-628-9082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175L00000X
OR5028175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath