Provider Demographics
NPI:1952810541
Name:MCCARTHY, ALICIA (ND)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:MCCARTHY
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 1:6714 SE 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5636
Mailing Address - Country:US
Mailing Address - Phone:714-813-8507
Mailing Address - Fax:
Practice Address - Street 1:16877 SW 65TH AVE
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-7865
Practice Address - Country:US
Practice Address - Phone:503-303-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175F00000X
OR4105175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath