MEDICARE: SEVEN-ONE ACUPUNCTURE CENTER

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	AC159834	OR

General Provider Information

NPI Number	:	1811244361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEVEN-ONE ACUPUNCTURE CENTER

Provider Business Mailing Address
First Line	:	8324 SE RHINE ST APT 22
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97266-2388
Country	:	US
Telephone Number	:	971-263-0264
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 SE POWELL BLVD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97206-2453
Country	:	US
Telephone Number	:	971-263-0264
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SHINICHI MORIOKA
Credential	:
Telephone Number	:	971-263-0264

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	07/13/2013

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