Provider Demographics
NPI:1740609692
Name:KINE FISCHLER ACUPUNCTURE & HERBS
Entity Type:Organization
Organization Name:KINE FISCHLER ACUPUNCTURE & HERBS
Other - Org Name:WILLOW TREE WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-281-0030
Mailing Address - Street 1:1607 NE 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1413
Mailing Address - Country:US
Mailing Address - Phone:503-281-0030
Mailing Address - Fax:
Practice Address - Street 1:2714 NE DUNCKLEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97212-1644
Practice Address - Country:US
Practice Address - Phone:503-281-0030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01259171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty