Provider Demographics
NPI:1477212488
Name:ADVANCED ACUPUNCTURE INC2
Entity Type:Organization
Organization Name:ADVANCED ACUPUNCTURE INC2
Other - Org Name:ADVANCED ACUPUNCTURE INC1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NOOSHIN
Authorized Official - Middle Name:NIKKI
Authorized Official - Last Name:MEDGHALCHY
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:503-908-0157
Mailing Address - Street 1:17040 PILKINGTON RD STE 211
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5587
Mailing Address - Country:US
Mailing Address - Phone:503-908-0157
Mailing Address - Fax:503-908-0187
Practice Address - Street 1:17040 PILKINGTON RD STE 211
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5587
Practice Address - Country:US
Practice Address - Phone:503-908-0157
Practice Address - Fax:503-908-0187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED ACUPUNCTURE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-17
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty