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General NPI Number Information
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NPI Number | 1518804434
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Entity Type | Organization
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Legal Business Name | QUALITY OF LIFE ACUPUNCTURE
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Dates
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Enumeration Date | 04/29/2026
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Last Update Date | 04/29/2026
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Provider Practice Location Address
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Address Line | 9735 SW SHADY LN STE 306
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City | TIGARD
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State | OR
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Zip | 97223-5481
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Country | US
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Telephone | 971-220-7312
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Fax | 971-220-7313
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Provider Business Mailing Address
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Address Line | 15984 NW RYEGRASS ST
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City | PORTLAND
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State | OR
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Zip | 97229-9214
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Country | US
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Telephone | 971-220-7312
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Fax | 971-220-7313
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Authorized Official
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Title or Position | DOCTOR OF ACUPUNCTURE
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Name | DR. BLAKE UNDERWOOD
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Credential | LAC
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Telephone | 971-220-7312
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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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