MEDICARE: MS. ROBIN MARCINKIEWICZ 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	AC00956	OR

General Provider Information

NPI Number	:	1104911577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROBIN MARCINKIEWICZ L. AC.

Provider Business Mailing Address
First Line	:	1777 MAPLE ST
Second Line	:	#24
City	:	WEST LINN
State	:	OR
Zip	:	97068-3575
Country	:	US
Telephone Number	:	503-656-3110
Fax Number	:	503-656-3110

Provider Business Practice Location Address
First Line	:	729 MOLALLA AVE
Second Line	:	SUITE 6
City	:	OREGON CITY
State	:	OR
Zip	:	97045-2654
Country	:	US
Telephone Number	:	503-656-3110
Fax Number	:	503-656-3110

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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