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General NPI Number Information
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NPI Number | 1417571480
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Entity Type | Organization
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Legal Business Name | DRAGON RISES CENTER FOR WHOLENESS
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 06/07/2020
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Provider Practice Location Address
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Address Line | 4852 SW SCHOLLS FERRY RD
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City | PORTLAND
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State | OR
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Zip | 97225-1698
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Country | US
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Telephone | 971-808-7178
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Fax | 503-200-1067
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Provider Business Mailing Address
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Address Line | 4852 SW SCHOLLS FERRY RD
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City | PORTLAND
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State | OR
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Zip | 97225-1698
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Country | US
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Telephone | 971-808-7178
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Fax | 503-200-1067
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Authorized Official
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Title or Position | OWNER
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Name | MELINDA EVELYN BARBARA WHEELER
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Credential | DSOM
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Telephone | 541-514-3166
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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 |
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License Number State |
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