Provider Demographics
NPI:1669544789
Name:STEPHENS, ERIC F (DAOM, L AC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:F
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:DAOM, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 SW ALDER ST STE 701
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-3115
Mailing Address - Country:US
Mailing Address - Phone:503-223-2845
Mailing Address - Fax:
Practice Address - Street 1:813 SW ALDER ST STE 701
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-3115
Practice Address - Country:US
Practice Address - Phone:503-223-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00046171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist