MEDICARE: ELIZA ROWLEY 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1588400659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIZA ROWLEY L.AC.

Provider Business Mailing Address
First Line	:	12165 SE OATFIELD RD
Second Line	:
City	:	MILWAUKIE
State	:	OR
Zip	:	97222-6950
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2080 SE OAK GROVE BLVD # 9
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97267-2657
Country	:	US
Telephone Number	:	503-389-5554
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZA ANN ROWLEY
Credential	:	L. AC.
Telephone Number	:	805-452-3193

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

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