Provider Demographics
NPI:1740588664
Name:AN SEN CLINIC LLC
Entity Type:Organization
Organization Name:AN SEN CLINIC LLC
Other - Org Name:ALYSIA ANDERSON
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-236-6633
Mailing Address - Street 1:107 SE WASHINGTON ST
Mailing Address - Street 2:SUITE 134
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2103
Mailing Address - Country:US
Mailing Address - Phone:503-236-6633
Mailing Address - Fax:503-234-2185
Practice Address - Street 1:107 SE WASHINGTON ST
Practice Address - Street 2:SUITE 134
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2103
Practice Address - Country:US
Practice Address - Phone:503-236-6633
Practice Address - Fax:503-234-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty