MEDICARE: MANDI TRIMAS 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	AC199307	OR

General Provider Information

NPI Number	:	1356010029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANDI TRIMAS L.AC.

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	:	503-575-9740
Fax Number	:

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	:	503-575-9740
Fax Number	:

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

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	10/28/2024

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Directions to “ MANDI TRIMAS L.AC.” Practice Location

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