=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346394343
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIC SCHLEICHER LAC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/23/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4838 NE SANDY BLVD SUITE 200
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97213-2091
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-287-1510
-----------------------------------------------------
Fax | 503-287-1505
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4838 NE SANDY BLVD SUITE 200
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97213-2091
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-287-1510
-----------------------------------------------------
Fax | 503-287-1505
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC00708
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------