Provider Demographics
NPI:1629781885
Name:NIGHT SKY ACUPUNCTURE
Entity type:Organization
Organization Name:NIGHT SKY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENHILL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-863-6342
Mailing Address - Street 1:811 E BURNSIDE ST STE 216
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1231
Mailing Address - Country:US
Mailing Address - Phone:503-863-6342
Mailing Address - Fax:
Practice Address - Street 1:811 E BURNSIDE ST STE 216
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1231
Practice Address - Country:US
Practice Address - Phone:503-863-6342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500812706Medicaid