Healthcare Provider Details

I. General information

NPI: 1881974673
Provider Name (Legal Business Name): ABIGAIL ELIZABETH IMSAND L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 SE 7TH ST STE B
GRANTS PASS OR
97526-3002
US

IV. Provider business mailing address

596 SCHROEDER LN
GRANTS PASS OR
97527-6117
US

V. Phone/Fax

Practice location:
  • Phone: 541-846-7384
  • Fax:
Mailing address:
  • Phone: 707-357-5618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC228090
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: