Provider Demographics
NPI:1235430125
Name:GIORDANO, COURTNEY N (LAC)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:N
Last Name:GIORDANO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 SE BELMONT ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4084
Mailing Address - Country:US
Mailing Address - Phone:503-505-9677
Mailing Address - Fax:
Practice Address - Street 1:2915 SE BELMONT ST STE 1
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4084
Practice Address - Country:US
Practice Address - Phone:503-505-9677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC153123171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist