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General NPI Number Information
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NPI Number | 1396324901
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Entity Type | Individual
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Provider Name | SANDRA GISSELLE GIL ROMERO LAC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 9520 SW BEAVERTON HILLSDALE HWY
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City | BEAVERTON
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State | OR
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Zip | 97005-3309
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Country | US
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Telephone | 503-433-8448
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Fax |
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Provider Business Mailing Address
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Address Line | 7472 SW 195TH PL
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City | BEAVERTON
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State | OR
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Zip | 97007-5519
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Country | US
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Telephone | 808-594-8120
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Fax |
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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 | AC203842
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License Number State | OR
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