MEDICARE: AMY NICOLE HOMER-BROWN MBBS, MSOM, LAC

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	AC196466	OR

General Provider Information

NPI Number	:	1093349490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY NICOLE HOMER-BROWN MBBS, MSOM, LAC

Provider Business Mailing Address
First Line	:	9600 SW OAK ST STE 410
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-6581
Country	:	US
Telephone Number	:	503-308-8676
Fax Number	:	503-821-7881

Provider Business Practice Location Address
First Line	:	9600 SW OAK ST STE 410
Second Line	:
City	:	TIGARD
State	:	OR
Zip	:	97223-6581
Country	:	US
Telephone Number	:	503-308-8676
Fax Number	:	503-821-7881

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

Provider Enumeration Date	:	02/25/2020
Last Update Date	:	01/01/2026

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