Provider Demographics
NPI:1669606786
Name:JORGE KAUFMANN, ND, LAC, LLC
Entity type:Organization
Organization Name:JORGE KAUFMANN, ND, LAC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAUFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:503-341-0907
Mailing Address - Street 1:9790 SW LYNWOOD TER
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-4339
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5215 NE ELAM YOUNG PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6498
Practice Address - Country:US
Practice Address - Phone:503-693-9101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC01126171100000X
OR1557175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty