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General NPI Number Information
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NPI Number | 1083269062
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Entity Type | Organization
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Legal Business Name | VELA WELLNESS LLC
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 7319 N JOHN AVE
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City | PORTLAND
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State | OR
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Zip | 97203-4885
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Country | US
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Telephone | 503-406-6487
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Fax |
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Provider Business Mailing Address
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Address Line | 7454 N MONTEITH AVE
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City | PORTLAND
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State | OR
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Zip | 97203-4265
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Country | US
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Telephone | 360-770-0191
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Fax |
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Authorized Official
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Title or Position | OWNER, ACUPUNCTURIST
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Name | ALLISON MACHEN
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Credential | LAC
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Telephone | 503-406-6487
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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 |
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License Number State |
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