Provider Demographics
NPI:1871032631
Name:INVIGORATE INJURY & INTEGRATIVE MEDICINE LLC
Entity Type:Organization
Organization Name:INVIGORATE INJURY & INTEGRATIVE MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-516-4554
Mailing Address - Street 1:527 SE BASELINE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4149
Mailing Address - Country:US
Mailing Address - Phone:503-994-9211
Mailing Address - Fax:503-660-4083
Practice Address - Street 1:527 SE BASELINE ST
Practice Address - Street 2:SUITE F
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4149
Practice Address - Country:US
Practice Address - Phone:503-994-9211
Practice Address - Fax:503-660-4083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC160714171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty