Provider Demographics
NPI:1780009084
Name:PEARSON, CHRISTINE R (L AC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:R
Last Name:PEARSON
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:619 NW 6TH AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3991
Mailing Address - Country:US
Mailing Address - Phone:503-988-5183
Mailing Address - Fax:
Practice Address - Street 1:5329 NE MARTIN LUTHER KING BLVD FL 5
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3237
Practice Address - Country:US
Practice Address - Phone:503-988-5182
Practice Address - Fax:971-347-2223
Is Sole Proprietor?:No
Enumeration Date:2014-02-23
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC163626171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist