Provider Demographics
NPI:1598432387
Name:BE WELL ACUPUNCTURE
Entity Type:Organization
Organization Name:BE WELL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-217-4457
Mailing Address - Street 1:3125 NE HOLLADAY ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2504
Mailing Address - Country:US
Mailing Address - Phone:503-217-4457
Mailing Address - Fax:
Practice Address - Street 1:4050 NE BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1828
Practice Address - Country:US
Practice Address - Phone:503-217-4457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BE WELL ACUPUNCTURE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty