Provider Demographics
NPI:1952074833
Name:HERRHYTHM ACUPUNCTURE AND REPRODUCTIVE WELLNESS, LLC
Entity Type:Organization
Organization Name:HERRHYTHM ACUPUNCTURE AND REPRODUCTIVE WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWANSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:608-769-5135
Mailing Address - Street 1:635 SE PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-7825
Mailing Address - Country:US
Mailing Address - Phone:608-769-5135
Mailing Address - Fax:503-893-3045
Practice Address - Street 1:223 E POWELL BLVD
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7605
Practice Address - Country:US
Practice Address - Phone:503-667-1500
Practice Address - Fax:503-893-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR156812OtherACUPUNCTURE LICENSE