Provider Demographics
NPI:1881131183
Name:SINGH, DALI (LMT)
Entity type:Individual
Prefix:
First Name:DALI
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:DIMPAL
Other - Middle Name:K
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7237 N FESSENDEN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-1820
Mailing Address - Country:US
Mailing Address - Phone:971-352-5915
Mailing Address - Fax:
Practice Address - Street 1:7237 N FESSENDEN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-1820
Practice Address - Country:US
Practice Address - Phone:971-352-5915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22100173C00000X, 405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional
No173C00000XOther Service ProvidersReflexologist