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General NPI Number Information
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NPI Number | 1871465799
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Entity Type | Organization
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Legal Business Name | TREE OF LIFE ORIENTAL MODALITIES
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 9161 SE FOSTER RD
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City | PORTLAND
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State | OR
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Zip | 97266-4619
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Country | US
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Telephone | 503-887-0078
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 SE 151ST AVE
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City | PORTLAND
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State | OR
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Zip | 97233-2920
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Country | US
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Telephone | 503-887-0078
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERICKA R DOOLEY
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Credential | LAC. MAOM
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Telephone | 503-887-0078
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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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