Provider Demographics
NPI:1063055630
Name:HORAN, SEAN PETER (ND)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PETER
Last Name:HORAN
Suffix:
Gender:X
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5118 SE POWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-3071
Mailing Address - Country:US
Mailing Address - Phone:971-258-0991
Mailing Address - Fax:971-438-0382
Practice Address - Street 1:5118 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-3071
Practice Address - Country:US
Practice Address - Phone:971-258-0991
Practice Address - Fax:971-438-0382
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4291175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath