Provider Demographics
NPI:1477841443
Name:UNIQUEACUPUNCTURE
Entity Type:Organization
Organization Name:UNIQUEACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MINJUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-475-2577
Mailing Address - Street 1:9999 SW WILSHIRE ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5019
Mailing Address - Country:US
Mailing Address - Phone:503-805-6455
Mailing Address - Fax:
Practice Address - Street 1:9999 SW WILSHIRE ST
Practice Address - Street 2:SUITE 212
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5019
Practice Address - Country:US
Practice Address - Phone:503-805-6455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC150767261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center