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General NPI Number Information
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NPI Number | 1114443124
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Entity Type | Organization
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Legal Business Name | ZEPHYR ACUPUNCTURE AND BODYWORK, LLC
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 08/22/2017
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Provider Practice Location Address
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Address Line | 4313 NE TILLAMOOK ST
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City | PORTLAND
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State | OR
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Zip | 97213-1315
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Country | US
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Telephone | 828-216-7326
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Fax |
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Provider Business Mailing Address
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Address Line | 355 NE 78TH AVE
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City | PORTLAND
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State | OR
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Zip | 97213-6338
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Country | US
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Telephone | 828-216-7326
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | SARAH CHASE
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Credential |
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Telephone | 828-216-7326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 164079
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License Number State | OR
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