Provider Demographics
NPI:1124563440
Name:ARIA WALKER, LAC
Entity Type:Organization
Organization Name:ARIA WALKER, LAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:ARIA
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-446-1960
Mailing Address - Street 1:1235 SE DIVISION ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1099
Mailing Address - Country:US
Mailing Address - Phone:503-446-1960
Mailing Address - Fax:888-653-7244
Practice Address - Street 1:1235 SE DIVISION ST
Practice Address - Street 2:SUITE 206
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1099
Practice Address - Country:US
Practice Address - Phone:503-446-1960
Practice Address - Fax:888-653-7244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC167797261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500688634OtherDMAP