Healthcare Provider Details

I. General information

NPI: 1558352047
Provider Name (Legal Business Name): ERIC STRAND LAC, DAC, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 08/15/2022
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 NE BURNSIDE RD STE 301
GRESHAM OR
97030-5705
US

IV. Provider business mailing address

1217 NE BURNSIDE RD STE 301
GRESHAM OR
97030-5705
US

V. Phone/Fax

Practice location:
  • Phone: 503-492-2625
  • Fax: 503-492-2355
Mailing address:
  • Phone: 503-492-2625
  • Fax: 503-492-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00635
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: