Provider Demographics
NPI:1659746097
Name:SEWELL, DELIA (ND)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:
Last Name:SEWELL
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 1:2822 SW 2ND AVE
Mailing Address - Street 2:UPPER UNIT
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-4744
Mailing Address - Country:US
Mailing Address - Phone:404-348-6227
Mailing Address - Fax:
Practice Address - Street 1:25500 SE STARK ST
Practice Address - Street 2:SUITE 102
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3331
Practice Address - Country:US
Practice Address - Phone:503-492-1327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3059175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath