Provider Demographics
NPI:1790058758
Name:COMMUNITY ALTERNATIVE MEDICINE
Entity Type:Organization
Organization Name:COMMUNITY ALTERNATIVE MEDICINE
Other - Org Name:NONE
Other - Org Type:Other Name
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCINKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:503-656-3110
Mailing Address - Street 1:PO BOX 632
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-0038
Mailing Address - Country:US
Mailing Address - Phone:503-656-3110
Mailing Address - Fax:
Practice Address - Street 1:619 MADISON ST
Practice Address - Street 2:SUITE 106
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-2354
Practice Address - Country:US
Practice Address - Phone:503-656-3110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00956261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service