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General NPI Number Information
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NPI Number | 1780826180
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Entity Type | Organization
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Legal Business Name | CAMAS ACUPUNCTURE & NUTRITION INC.
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 04/04/2014
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Provider Practice Location Address
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Address Line | 405 NE 6TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2037
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Country | US
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Telephone | 360-210-7989
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Fax |
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Provider Business Mailing Address
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Address Line | 405 NE 6TH AVE
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City | CAMAS
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State | WA
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Zip | 98607-2037
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Country | US
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Telephone | 360-210-7989
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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 | STEPHANIE L MEINHOLD
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Credential | LAC
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Telephone | 360-210-7989
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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 | AC60054013
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License Number State | WA
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