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General NPI Number Information
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NPI Number | 1356727291
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Entity Type | Organization
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Legal Business Name | DISCOVERY ACUPUNCTURE
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 4160 SE DIVISION ST
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City | PORTLAND
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State | OR
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Zip | 97202-1647
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Country | US
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Telephone | 503-564-0179
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Fax |
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Provider Business Mailing Address
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Address Line | 27818 SW GRAHAMS FERRY RD
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City | SHERWOOD
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State | OR
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Zip | 97140-8419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATEO STEFFECK
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Credential | L.AC
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Telephone | 503-550-5658
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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 | AC170305
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License Number State | OR
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