Provider Demographics
NPI:1568653491
Name:MAZZEI, AMELIA ELIZABETH AIBINA (ND, MPH)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:ELIZABETH AIBINA
Last Name:MAZZEI
Suffix:
Gender:F
Credentials:ND, MPH
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:
Other - Last Name:IMLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 NE OREGON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2162
Mailing Address - Country:US
Mailing Address - Phone:971-917-1971
Mailing Address - Fax:
Practice Address - Street 1:800 NE OREGON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2162
Practice Address - Country:US
Practice Address - Phone:971-917-1971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3050175F00000X
372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No372600000XNursing Service Related ProvidersAdult Companion