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NPI Code Detail

MEDICARE: BE WELL ACUPUNCTURE

MEDICARE: BE WELL ACUPUNCTURE
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
1171100000XAcupuncturist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336878875
Entity Type Code : Organization
Provider Name (Legal Business Name) : BE WELL ACUPUNCTURE
Provider Business Mailing Address
First Line : 3125 NE HOLLADAY ST UNIT B
Second Line :
City : PORTLAND
State : OR
Zip : 97232-2504
Country : US
Telephone Number : 503-217-4457
Fax Number :
Provider Business Practice Location Address
First Line : 3735 SE DIVISION ST
Second Line :
City : PORTLAND
State : OR
Zip : 97202-1547
Country : US
Telephone Number : 503-217-4457
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DESSA MARIE BINGLEY
Credential : LAC
Telephone Number : 503-217-4457
Provider Enumeration Date : 06/09/2022
Last Update Date : 06/09/2022

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Directions to “BE WELL ACUPUNCTURE ” Practice Location

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