Provider Demographics
NPI:1952673030
Name:FORSTEN, CORA VICTORIA JACOBINE (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:CORA
Middle Name:VICTORIA JACOBINE
Last Name:FORSTEN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
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Mailing Address - Street 1:1110 SE ALDER ST STE 201
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2400
Mailing Address - Country:US
Mailing Address - Phone:503-477-5051
Mailing Address - Fax:503-477-5051
Practice Address - Street 1:1110 SE ALDER ST STE 201
Practice Address - Street 2:SUITE 201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2400
Practice Address - Country:US
Practice Address - Phone:503-477-5051
Practice Address - Fax:503-477-5051
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORAC155930171100000X
OR1869175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist