MEDICARE: MEGAN MAHONY LAC

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

General Provider Information

NPI Number	:	1669213211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MAHONY LAC

Provider Business Mailing Address
First Line	:	880 BICKNER ST
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-4814
Country	:	US
Telephone Number	:	503-908-3803
Fax Number	:

Provider Business Practice Location Address
First Line	:	15110 BOONES FERRY RD STE 350
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-3461
Country	:	US
Telephone Number	:	503-908-3803
Fax Number	:

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

Provider Enumeration Date	:	06/05/2024
Last Update Date	:	01/12/2026

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Directions to “ MEGAN MAHONY LAC” Practice Location

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