MEDICARE: MR. DAVID HARLEY FRIERMAN L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC00131	OR

General Provider Information

NPI Number	:	1184996142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID HARLEY FRIERMAN L.AC.

Provider Business Mailing Address
First Line	:	4134 SE 14TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-3922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4134 SE 14TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-3922
Country	:	US
Telephone Number	:	503-233-9827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2012
Last Update Date	:	02/06/2012

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Directions to “ MR. DAVID HARLEY FRIERMAN L.AC.” Practice Location

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