Healthcare Provider Details
I. General information
NPI: 1477606101
Provider Name (Legal Business Name): CHERYL ANN KALSCH-LOWRANCE LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
343 SE 3RD AVE
HILLSBORO OR
97123-4001
US
IV. Provider business mailing address
343 SE 3RD AVE
HILLSBORO OR
97123-4001
US
V. Phone/Fax
- Phone: 503-844-9355
- Fax: 503-844-9355
- Phone: 503-844-9355
- Fax: 503-844-9355
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC01023 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: