Provider Demographics
NPI:1255651972
Name:RELEASE LLC
Entity Type:Organization
Organization Name:RELEASE LLC
Other - Org Name:RELEASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-810-8589
Mailing Address - Street 1:PO BOX 42004
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97242-0004
Mailing Address - Country:US
Mailing Address - Phone:503-810-8589
Mailing Address - Fax:
Practice Address - Street 1:5308 SE RHONE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-2962
Practice Address - Country:US
Practice Address - Phone:503-810-8589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00828171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty