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NPI Code Detail

MEDICARE: GIBRAN K RAMOS N.D., L.AC

MEDICARE: GIBRAN K RAMOS N.D., 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
1171100000XAcupuncturistAC150207OR
2175F00000XNaturopath1821OR

General Provider Information

NPI Number : 1962735217
Entity Type Code : Individual
Provider Name (Legal Business Name) : GIBRAN K RAMOS N.D., L.AC
Provider Business Mailing Address
First Line : 4110 SE HAWTHORNE BLVD # 178
Second Line :
City : PORTLAND
State : OR
Zip : 97214-5246
Country : US
Telephone Number : 503-482-9092
Fax Number : 503-715-5789
Provider Business Practice Location Address
First Line : 7477 SE 52ND AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97206-8206
Country : US
Telephone Number : 503-482-9092
Fax Number : 503-715-5789
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2009
Last Update Date : 08/12/2024

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