Provider Demographics
NPI:1497995583
Name:ACUPUNCTURE NORTHWEST
Entity Type:Organization
Organization Name:ACUPUNCTURE NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-493-9389
Mailing Address - Street 1:2256 N ALBINA AVE STE 190
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1778
Mailing Address - Country:US
Mailing Address - Phone:503-493-9389
Mailing Address - Fax:503-493-9082
Practice Address - Street 1:2256 N ALBINA AVE STE 190
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1778
Practice Address - Country:US
Practice Address - Phone:503-493-9389
Practice Address - Fax:503-493-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty