Provider Demographics
NPI:1467094110
Name:WO, JOHN (L AC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:WO
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4931 MANA PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-4009
Mailing Address - Country:US
Mailing Address - Phone:808-732-2699
Mailing Address - Fax:
Practice Address - Street 1:718 SW ALDER ST STE 218
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3423
Practice Address - Country:US
Practice Address - Phone:503-704-7588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty