Provider Demographics
NPI:1841721495
Name:ACUPUNCTURE CASCADIA
Entity type:Organization
Organization Name:ACUPUNCTURE CASCADIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-797-9953
Mailing Address - Street 1:1744 NE TAURUS CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-6472
Mailing Address - Country:US
Mailing Address - Phone:541-797-9962
Mailing Address - Fax:541-610-1557
Practice Address - Street 1:31 NW GREELEY AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2911
Practice Address - Country:US
Practice Address - Phone:541-797-3412
Practice Address - Fax:541-610-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC171863171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty