Provider Demographics
NPI:1083311484
Name:BLOSSOMING SPRING ACUPUNCTURE
Entity Type:Organization
Organization Name:BLOSSOMING SPRING ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:FLORA
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:503-381-1765
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-0011
Mailing Address - Country:US
Mailing Address - Phone:503-381-1765
Mailing Address - Fax:971-242-4109
Practice Address - Street 1:419 CENTER ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2211
Practice Address - Country:US
Practice Address - Phone:503-381-1765
Practice Address - Fax:971-242-4109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty