MEDICARE: WANDERING STONE ACUPUNCTURE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033766001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WANDERING STONE ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	1524 NE HANCOCK ST APT 2
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-4472
Country	:	US
Telephone Number	:	360-223-4533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 NE HANCOCK ST APT 2
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97212-4472
Country	:	US
Telephone Number	:	360-223-4533
Fax Number	:

Authorized Official
Title or Position	:	LAC
Name	:	HOLLY ANN POLINKUS
Credential	:	LAC
Telephone Number	:	360-223-4533

Provider Enumeration Date	:	08/23/2019
Last Update Date	:	08/23/2019

Similar Medicare Providers

1477417160 — MELISSA LONEMAN
Practice Location Address:

703 NE HANCOCK ST
PORTLAND, OR
97212-3955

Practice Phone: 503-230-9875
Practice Fax: 503-331-3441

1922962620 — CHARLOTTE MAEVE LYNCH
Practice Location Address:

2330 NE SISKIYOU ST
PORTLAND, OR
97212-2471

Practice Phone: 503-528-0757
Practice Fax:

1750246872 — KERRY ELLEN GRETHER
Practice Location Address:

3928 NE 13TH AVE
PORTLAND, OR
97212-1305

Practice Phone: 503-956-2579
Practice Fax:

1124897244 — ABIGAIL MAE MCBEE RN
Practice Location Address:

703 NE HANCOCK ST
PORTLAND, OR
97212-3955

Practice Phone: 503-230-9875
Practice Fax: 503-331-3441

1558224865 — ARIEL MARSH
Practice Location Address:

3727 NE 12TH AVE
PORTLAND, OR
97212-1241

Practice Phone: 971-533-2617
Practice Fax:

1821951088 — NICOLE ROGERS
Practice Location Address:

3716 NE MARTIN LUTHER KING BLVD
PORTLAND, OR
97212-1111

Practice Phone: 502-288-8036
Practice Fax:

Directions to “WANDERING STONE ACUPUNCTURE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.