Provider Demographics
NPI:1659153609
Name:DESCHUTES ACUPUNCTURE & CHINESE MEDICINE, INC
Entity Type:Organization
Organization Name:DESCHUTES ACUPUNCTURE & CHINESE MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:541-323-0294
Mailing Address - Street 1:339 SW CENTURY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1199
Mailing Address - Country:US
Mailing Address - Phone:541-323-0294
Mailing Address - Fax:
Practice Address - Street 1:339 SW CENTURY DR STE 103
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1199
Practice Address - Country:US
Practice Address - Phone:541-429-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty