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General NPI Number Information
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NPI Number | 1851106231
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Entity Type | Individual
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Provider Name | GRACE RODRIGUEZ DACM, LAC
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Gender | Female
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1836 NE 7TH AVE STE 109
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City | PORTLAND
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State | OR
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Zip | 97212-3996
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Country | US
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Telephone | 503-383-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 3539 SE MILWAUKIE AVE APT 203
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City | PORTLAND
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State | OR
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Zip | 97202-2770
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Country | US
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Telephone | 719-352-1726
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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 | AC223724
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License Number State | OR
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