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General NPI Number Information
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NPI Number | 1336381169
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Entity Type | Organization
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Legal Business Name | MATHEWS ACUPUNCTURE LLC
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Dates
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Enumeration Date | 03/25/2009
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 6274 SW CAPITOL HWY
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City | PORTLAND
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State | OR
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Zip | 97239-2674
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Country | US
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Telephone | 503-892-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 6274 SW CAPITOL HWY
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City | PORTLAND
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State | OR
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Zip | 97239-2674
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Country | US
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Telephone | 503-892-8285
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | MONICA MATHEWS
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Credential | L.AC.
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Telephone | 503-892-8285
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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 | AC00898
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License Number State | OR
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