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General NPI Number Information
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NPI Number | 1801788054
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Entity Type | Organization
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Legal Business Name | GODDESS ATHENA ACUPUNCTURE AND HOLISTIC HEALING
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 6638 NE SANDY BLVD
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City | PORTLAND
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State | OR
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Zip | 97213-5250
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Country | US
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Telephone | 541-912-5646
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Fax |
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Provider Business Mailing Address
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Address Line | 5151 SE HOLGATE BLVD APT 408
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City | PORTLAND
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State | OR
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Zip | 97206-3887
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Country | US
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Telephone | 541-912-5646
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RACHEL HINNEN
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Credential |
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Telephone | 541-912-5646
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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 |
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License Number State |
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