Provider Demographics
NPI:1184899924
Name:CYNTHIA CORY, L.AC., PC
Entity type:Organization
Organization Name:CYNTHIA CORY, L.AC., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:CORY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:503-317-4881
Mailing Address - Street 1:3504 NE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-2116
Mailing Address - Country:US
Mailing Address - Phone:503-317-4881
Mailing Address - Fax:
Practice Address - Street 1:2348 NW LOVEJOY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3022
Practice Address - Country:US
Practice Address - Phone:503-224-7224
Practice Address - Fax:503-224-1345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00348171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty