MEDICARE: AMBER M ROBIDOUX L.AC, L.M.T, C.S.T.

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	AC156926	OR

General Provider Information

NPI Number	:	1457624421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER M ROBIDOUX L.AC, L.M.T, C.S.T.

Provider Business Mailing Address
First Line	:	9030 SE OAK ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97216-1636
Country	:	US
Telephone Number	:	541-292-0663
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 B AVE
Second Line	:	SUITE 225
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-3159
Country	:	US
Telephone Number	:	541-292-0663
Fax Number	:

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

Provider Enumeration Date	:	02/21/2012
Last Update Date	:	06/29/2015

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