Provider Demographics
NPI:1043557838
Name:ACUPUNCTURE CENTER OF PORTLAND, INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE CENTER OF PORTLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:F
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM, L AC
Authorized Official - Phone:503-223-2845
Mailing Address - Street 1:813 SW ALDER
Mailing Address - Street 2:SUITE 701
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205
Mailing Address - Country:US
Mailing Address - Phone:503-223-2845
Mailing Address - Fax:
Practice Address - Street 1:813 SW ALDER ST
Practice Address - Street 2:SUITE 701
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3121
Practice Address - Country:US
Practice Address - Phone:503-223-2845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center