Provider Demographics
NPI:1285037903
Name:DUNLAP, CORINA L (ND, MS)
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:L
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:ND, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2067 NW LOVEJOY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1515
Mailing Address - Country:US
Mailing Address - Phone:503-222-2322
Mailing Address - Fax:
Practice Address - Street 1:2067 NW LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1515
Practice Address - Country:US
Practice Address - Phone:503-222-2322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2052175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath