Provider Demographics
NPI:1073880217
Name:ORLANDO, SEAN (LAC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:ORLANDO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 NE SCHUYLER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-4557
Mailing Address - Country:US
Mailing Address - Phone:928-225-0896
Mailing Address - Fax:
Practice Address - Street 1:1804 NE MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-3980
Practice Address - Country:US
Practice Address - Phone:928-225-0896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004631171100000X
ORAC157561171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist