Provider Demographics
NPI:1215201827
Name:SOPRANI, JOSEPH L (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:L
Last Name:SOPRANI
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 1:811 NW 20TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1443
Mailing Address - Country:US
Mailing Address - Phone:503-241-7050
Mailing Address - Fax:503-241-7050
Practice Address - Street 1:811 NW 20TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1443
Practice Address - Country:US
Practice Address - Phone:503-241-7050
Practice Address - Fax:503-241-7050
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00143171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist