Provider Demographics
NPI:1518625292
Name:PATRICK ALLEN ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:PATRICK ALLEN ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-929-6470
Mailing Address - Street 1:326 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:STAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97383-1726
Mailing Address - Country:US
Mailing Address - Phone:503-929-6470
Mailing Address - Fax:
Practice Address - Street 1:326 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1726
Practice Address - Country:US
Practice Address - Phone:503-929-6470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty