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General NPI Number Information
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NPI Number | 1699581355
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Entity Type | Organization
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Legal Business Name | INNER WAY WELLNESS, LLC
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Dates
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Enumeration Date | 12/07/2024
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Last Update Date | 12/07/2024
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Provider Practice Location Address
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Address Line | 5311 SE POWELL BLVD STE 202
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City | PORTLAND
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State | OR
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Zip | 97206-2951
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Country | US
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Telephone | 35-681-8625
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Fax | 971-228-1672
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Provider Business Mailing Address
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Address Line | 5311 SE POWELL BLVD STE 202
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City | PORTLAND
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State | OR
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Zip | 97206-2951
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Country | US
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Telephone | 310-266-3206
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Fax | 971-228-1672
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Authorized Official
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Title or Position | CHINESE MEDICINE PRACTITIONER
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Name | DR. TAYLOR FLOHR
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Credential | DACM, LAC
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Telephone | 503-568-1862
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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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