Healthcare Provider Details

I. General information

NPI: 1952074833
Provider Name (Legal Business Name): HERRHYTHM ACUPUNCTURE AND REPRODUCTIVE WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 E POWELL BLVD
GRESHAM OR
97030-7605
US

IV. Provider business mailing address

635 SE PARK DR
GRESHAM OR
97080-7825
US

V. Phone/Fax

Practice location:
  • Phone: 503-667-1500
  • Fax: 503-893-3045
Mailing address:
  • Phone: 608-769-5135
  • Fax: 503-893-3045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier156812
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerACUPUNCTURE LICENSE

VIII. Authorized Official

Name: STEPHANIE SWANSON
Title or Position: OWNER
Credential: LAC
Phone: 608-769-5135