Provider Demographics
NPI:1073086062
Name:ALLMACHER, LAURA A (LAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:ALLMACHER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 SE 16TH AVE APT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2768
Mailing Address - Country:US
Mailing Address - Phone:517-420-0806
Mailing Address - Fax:
Practice Address - Street 1:819 SE MORRISON ST STE 115
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6308
Practice Address - Country:US
Practice Address - Phone:503-956-9396
Practice Address - Fax:503-206-4791
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC190118171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty