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NPI Code Detail

MEDICARE: DR. ILANA GUREVICH ND, LAC

MEDICARE: DR. ILANA GUREVICH ND, 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
1171100000XAcupuncturistAC01232OR
2175F00000XNaturopath1580OR

General Provider Information

NPI Number : 1225218977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ILANA GUREVICH ND, LAC
Provider Business Mailing Address
First Line : 1901 N KILLINGSWORTH ST
Second Line :
City : PORTLAND
State : OR
Zip : 97217-4436
Country : US
Telephone Number : 503-770-0670
Fax Number : 833-450-6082
Provider Business Practice Location Address
First Line : 1901 N KILLINGSWORTH ST
Second Line :
City : PORTLAND
State : OR
Zip : 97217-4436
Country : US
Telephone Number : 503-770-0670
Fax Number : 833-450-6082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2007
Last Update Date : 05/08/2025

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