MEDICARE: DR. ARLETTE K. SIECKMAN N.D., L.AC.

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	AC00079	OR
2	175F00000X	Naturopath	0632	OR

General Provider Information

NPI Number	:	1063664167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARLETTE K. SIECKMAN N.D., L.AC.

Provider Business Mailing Address
First Line	:	13300 KNAUS RD
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-1542
Country	:	US
Telephone Number	:	503-699-7199
Fax Number	:	503-697-8174

Provider Business Practice Location Address
First Line	:	13300 KNAUS RD
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-1542
Country	:	US
Telephone Number	:	503-699-7199
Fax Number	:	503-697-8174

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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