MEDICARE: EXPEDITION 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
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1629535653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPEDITION ACUPUNCTURE

Provider Business Mailing Address
First Line	:	80 SE MADISON ST STE 216
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-4527
Country	:	US
Telephone Number	:	503-748-9399
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 SE MADISON ST STE 216
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97214-4527
Country	:	US
Telephone Number	:	503-748-9399
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MASON MOORE
Credential	:	LAC, LMT
Telephone Number	:	503-748-9399

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	09/11/2025

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Directions to “EXPEDITION ACUPUNCTURE ” Practice Location

Language	Start Address	Practice Location

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