MEDICARE: ANGELA PARSON 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
2	171100000X	Acupuncturist	AC00506	OR

General Provider Information

NPI Number	:	1144418708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA PARSON L.AC.

Provider Business Mailing Address
First Line	:	5423 NE 41ST AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-8044
Country	:	US
Telephone Number	:	971-235-9189
Fax Number	:

Provider Business Practice Location Address
First Line	:	2304 E BURNSIDE ST STE 4
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-1677
Country	:	US
Telephone Number	:	971-235-9189
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	06/26/2024

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