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General NPI Number Information
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NPI Number | 1487026480
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Entity Type | Organization
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Legal Business Name | LUNA ACUPUNCTURE & WELLNESS CENTER LLC
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Dates
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Enumeration Date | 10/29/2015
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Last Update Date | 10/29/2015
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Provider Practice Location Address
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Address Line | 14631 SW MILLIKAN WAY SUITE 6
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City | BEAVERTON
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State | OR
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Zip | 97003-2999
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Country | US
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Telephone | 503-853-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 14631 SW MILLIKAN WAY SUITE 6
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City | BEAVERTON
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State | OR
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Zip | 97003-2999
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Country | US
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Telephone | 503-853-2866
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Fax |
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Authorized Official
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Title or Position | OWNER & ACUPUNCTURIST
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Name | MR. JAMES CARTER
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Credential | L.AC
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Telephone | 503-853-2866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | AC175035
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License Number State | OR
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