Provider Demographics
NPI:1245557909
Name:GROUNDSPRING HEALING CENTER, P.C.
Entity Type:Organization
Organization Name:GROUNDSPRING HEALING CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-244-1330
Mailing Address - Street 1:9130 SW TRAIL CT.
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4369
Mailing Address - Country:US
Mailing Address - Phone:503-244-1330
Mailing Address - Fax:971-244-0248
Practice Address - Street 1:8283 SW BARBUR BLVD.
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-2871
Practice Address - Country:US
Practice Address - Phone:503-244-1330
Practice Address - Fax:971-244-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00595171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty