Healthcare Provider Details

I. General information

NPI: 1497670186
Provider Name (Legal Business Name): COLIBRI ACUPUNCTURE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12615 NE HALSEY ST
PORTLAND OR
97230-1930
US

IV. Provider business mailing address

12615 NE HALSEY ST
PORTLAND OR
97230-1930
US

V. Phone/Fax

Practice location:
  • Phone: 714-655-2095
  • Fax: 503-447-6044
Mailing address:
  • Phone: 714-655-2095
  • Fax: 503-447-6044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANDRES CARDENAS
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 714-655-2095