Healthcare Provider Details

I. General information

NPI: 1609091024
Provider Name (Legal Business Name): JOYCE MAE TOWNE L.AC. OREGON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

492 W BROADWAY
EUGENE OR
97401-2834
US

IV. Provider business mailing address

1661 ACORN PARK ST
EUGENE OR
97402-3135
US

V. Phone/Fax

Practice location:
  • Phone: 541-968-5152
  • Fax:
Mailing address:
  • Phone: 541-968-5152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0786
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: