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General NPI Number Information
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NPI Number | 1316138381
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Entity Type | Individual
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Provider Name | LISA R. POOL L.AC
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Gender | Female
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 119 NE 3RD ST
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City | MCMINNVILLE
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State | OR
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Zip | 97128-4901
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Country | US
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Telephone | 503-474-7446
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Fax | 866-454-3484
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Provider Business Mailing Address
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Address Line | 119 NE 3RD ST
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City | MCMINNVILLE
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State | OR
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Zip | 97128-4901
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Country | US
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Telephone | 503-474-7446
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Fax | 866-454-3484
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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 | AC01147
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License Number State | OR
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