| |
2456 Nw Northrup St, 1a, Portland, OR 97210-3253 | |
(503) 223-7067 | |
(503) 223-9639 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Primary Care |
Location | 2456 Nw Northrup St, Portland, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366820888 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | AC00112 (Oregon) | Secondary |
261QP2300X | Clinic/center - Primary Care | 18005 (Oregon) | Primary |
Mailing Address | Practice Location Address |
---|---|
2456 Nw Northrup St, Suite 1a, Portland, OR 97210-3253 Ph: (503) 223-7067 | 2456 Nw Northrup St, 1a, Portland, OR 97210-3253 Ph: (503) 223-7067 |