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NPI Code Detail

MEDICARE: RELEASE LLC

MEDICARE: RELEASE LLC
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
1171100000XAcupuncturistAC00828OR

General Provider Information

NPI Number : 1255651972
Entity Type Code : Organization
Provider Name (Legal Business Name) : RELEASE LLC
Provider Business Mailing Address
First Line : PO BOX 42004
Second Line :
City : PORTLAND
State : OR
Zip : 97242-0004
Country : US
Telephone Number : 503-810-8589
Fax Number :
Provider Business Practice Location Address
First Line : 5308 SE RHONE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97206-2962
Country : US
Telephone Number : 503-810-8589
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : MR. TIMOTHY ENG
Credential : L.AC.
Telephone Number : 503-810-8589
Provider Enumeration Date : 06/04/2010
Last Update Date : 06/04/2010

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Directions to “RELEASE LLC ” Practice Location

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