Provider Demographics
NPI:1356679062
Name:SIERACKI, ROLAND MICHAEL (LAC, DIPLOM,CKTP)
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:MICHAEL
Last Name:SIERACKI
Suffix:
Gender:M
Credentials:LAC, DIPLOM,CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:596 E. FIFTH AVE., SUITE #314
Mailing Address - Street 2:REDWOOD TCM, ROLAND SIERACKI, L.AC.,DIPL.O.M., CKTP
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-505-9551
Mailing Address - Fax:
Practice Address - Street 1:596 E. FIFTH AVE., SUITE #314
Practice Address - Street 2:REDWOOD TCM, ROLAND SIERACKI, L.AC.,DIPL.O.M., CKTP
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:541-556-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC150264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist