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General NPI Number Information
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NPI Number | 1093959868
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Entity Type | Individual
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Provider Name | MARGUERITE ANNE CELESTE LAC, LMT
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Gender | Female
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 107 SE WASHINGTON ST STE 134
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City | PORTLAND
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State | OR
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Zip | 97214-2151
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Country | US
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Telephone | 503-239-2639
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Fax |
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Provider Business Mailing Address
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Address Line | 107 SE WASHINGTON ST STE 134
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City | PORTLAND
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State | OR
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Zip | 97214-2151
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Country | US
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Telephone | 503-239-2639
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | ACU-1115
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 11590
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MAT-12433
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 177230
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License Number State | OR
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