Healthcare Provider Details

I. General information

NPI: 1639114051
Provider Name (Legal Business Name): LAURA JEAN VALVERDE RN, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12655 SW CENTER ST STE 140
BEAVERTON OR
97005-1600
US

IV. Provider business mailing address

12655 SW CENTER ST STE 140
BEAVERTON OR
97005-1600
US

V. Phone/Fax

Practice location:
  • Phone: 503-756-2743
  • Fax:
Mailing address:
  • Phone: 303-931-9992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC225895
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: