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General NPI Number Information
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NPI Number | 1508487752
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Entity Type | Organization
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Legal Business Name | PANACEA HEALTH & WELLNESS, LLC
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | 5000 SW BUTTERNUT PL
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City | BEAVERTON
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State | OR
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Zip | 97078-2403
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Country | US
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Telephone | 503-278-6377
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 SW BUTTERNUT PL
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City | BEAVERTON
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State | OR
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Zip | 97078-2403
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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 | ND, LAC
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Name | SYDNEY HWANG
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Credential | ND, LAC
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Telephone | 503-278-6377
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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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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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