Provider Demographics
NPI:1558719153
Name:ADVANCED HEALING
Entity Type:Organization
Organization Name:ADVANCED HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GAZZINI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:914-282-9300
Mailing Address - Street 1:10330 SE 32ND AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6587
Mailing Address - Country:US
Mailing Address - Phone:503-659-8900
Mailing Address - Fax:503-659-8906
Practice Address - Street 1:10330 SE 32ND AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6587
Practice Address - Country:US
Practice Address - Phone:503-659-8900
Practice Address - Fax:503-659-8906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC174799171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty