Crupper, Mia Marin- Peck

Crupper, Mia Marin- Peck is an individual health care provider with primary practice located at 4259 Ne Broadway St , Portland OR 97213-1421. She recently has 4 registered licenses in different health care specialties including Other Service Providers / Naturopath, Other Service Providers / Specialist, Other Service Providers / Midwife, Nursing Service Related Providers / Doula. Other Service Providers / Naturopath is her primary health care specialty. Crupper, Mia Marin- Peck can be contacted via phone (503) 235-2259.

Contact Information

Primary practice address
4259 Ne Broadway St Portland OR 97213-1421
Phone: (503) 235-2259
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X 1481 Oregon
Other Service Providers / Specialist 174400000X 7621 Oregon
Other Service Providers / Midwife 176B00000X
Nursing Service Related Providers / Doula 374J00000X

Profile Details

NPI number 1609992650
LBN Legal business name Crupper, Mia Marin- Peck
Credentials N.D., L.M.T
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2007
Last updated Feb 7th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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