Provider Demographics
NPI:1346371457
Name:YAMAGUCHI HEALING ARTS, LLC
Entity Type:Organization
Organization Name:YAMAGUCHI HEALING ARTS, LLC
Other - Org Name:GRESHAM ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:YAMAGUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-667-8988
Mailing Address - Street 1:4322 SE 182ND AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030
Mailing Address - Country:US
Mailing Address - Phone:503-667-8988
Mailing Address - Fax:503-667-8976
Practice Address - Street 1:4322 SE 182ND AVE
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030
Practice Address - Country:US
Practice Address - Phone:503-667-8988
Practice Address - Fax:503-667-8976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00745171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty