Alter Image, Inc.

NPI #1679199335 in Portland, Oregon

Provider Information

NPI Number: 1679199335
Entity Type: Organization
Organization Name: Alter Image, Inc.
Primary Specialty: Specialist
Enumeration Date: Jun 18, 2020
Last Updated: Jun 18, 2020

Practice Location

Address: 2340 SE GLADSTONE ST
City: Portland
State: Oregon
ZIP Code: 97202-2962
Phone: (503) 267-3166

Authorized Official

Name: EVA B KOZLOWSKI, LE, CPE
Title: OWNER
Phone: (503) 267-3166

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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