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General NPI Number Information
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NPI Number | 1043698756
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE & NATURAL MEDICINE CLINIC, LLC
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 1355 S HEMLOCK ST
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City | CANNON BEACH
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State | OR
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Zip | 97110-3055
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Country | US
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Telephone | 503-436-2255
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Fax | 888-653-7244
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Provider Business Mailing Address
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Address Line | PO BOX 1292
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City | CANNON BEACH
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State | OR
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Zip | 97110-1292
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Country | US
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Telephone | 503-436-2255
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Fax | 888-653-7244
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Authorized Official
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Title or Position | OWNER, ACUPUNCTURIST
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Name | MS. RACHELLE ARIA WALKER
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Credential | L.AC.
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Telephone | 503-436-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC167797
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License Number State | OR
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