Healthcare Provider Details

I. General information

NPI: 1821315201
Provider Name (Legal Business Name): ARAM LEVENDOSKY L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21907 SW SHERWOOD BLVD
SHERWOOD OR
97140-9326
US

IV. Provider business mailing address

16004 SW TUALATIN SHERWOOD RD # 232
SHERWOOD OR
97140-8521
US

V. Phone/Fax

Practice location:
  • Phone: 503-236-3925
  • Fax: 503-625-0304
Mailing address:
  • Phone: 503-236-3925
  • Fax: 503-625-0304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC150451
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: