Healthcare Provider Details

I. General information

NPI: 1235239203
Provider Name (Legal Business Name): ACORN HEALING ARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 SW SUNSET BLVD SUITE E
PORTLAND OR
97239-2641
US

IV. Provider business mailing address

704 SE UMATILLA ST
PORTLAND OR
97202-6439
US

V. Phone/Fax

Practice location:
  • Phone: 503-245-1459
  • Fax: 503-293-2023
Mailing address:
  • Phone: 503-234-2285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number092000262N5
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number092000262N5
License Number StateOR

VIII. Authorized Official

Name: MS. MORI J MONTAGNE
Title or Position: OWNER/PROVIDER
Credential: NMNP
Phone: 503-245-1459