Provider Demographics
NPI:1013175892
Name:AWAKENING LOTUS HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AWAKENING LOTUS HEALTH CARE, INC.
Other - Org Name:DBA DAWN-STARR CROWTHER, LAC, LMT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN-STARR
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWTHER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT, DIPL AC
Authorized Official - Phone:503-422-7455
Mailing Address - Street 1:9900 SW WILSHIRE ST STE 190-A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5035
Mailing Address - Country:US
Mailing Address - Phone:502-422-7455
Mailing Address - Fax:503-297-3827
Practice Address - Street 1:9900 SW WILSHIRE ST STE 190-A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5035
Practice Address - Country:US
Practice Address - Phone:502-422-7455
Practice Address - Fax:503-297-3827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00731171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1538130901OtherINDIVIDUAL NPI