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General NPI Number Information
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NPI Number | 1568230225
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Entity Type | Individual
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Provider Name | RAMA VASUDEVAN L.AC
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Gender | Female
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 1975 NW 167TH PL STE 100-14
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City | BEAVERTON
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State | OR
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Zip | 97006-4908
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Country | US
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Telephone | 971-435-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 11294 NW MANTRA LN
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City | PORTLAND
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State | OR
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Zip | 97229-4893
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Country | US
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Telephone | 503-961-2854
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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 | AC217740
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License Number State | OR
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