Provider Demographics
NPI:1023380292
Name:BRETT CSORDAS, LAC
Entity Type:Organization
Organization Name:BRETT CSORDAS, LAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CSORDAS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-841-2000
Mailing Address - Street 1:1225 NW MURRAY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-5572
Mailing Address - Country:US
Mailing Address - Phone:503-841-2000
Mailing Address - Fax:
Practice Address - Street 1:1225 NW MURRAY RD STE 102
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-5572
Practice Address - Country:US
Practice Address - Phone:503-841-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01018171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty