Provider Demographics
NPI:1134664741
Name:RIVERS FLOW ACUPUNCTURE NW, LLC
Entity Type:Organization
Organization Name:RIVERS FLOW ACUPUNCTURE NW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, EAMP
Authorized Official - Phone:971-229-4051
Mailing Address - Street 1:10 NW 20TH AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1947
Mailing Address - Country:US
Mailing Address - Phone:360-836-0919
Mailing Address - Fax:360-984-6580
Practice Address - Street 1:513 N MORRISON RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1432
Practice Address - Country:US
Practice Address - Phone:360-836-0919
Practice Address - Fax:360-984-6580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60706393171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty