MEDICARE: O'NEILL ORIENTAL MEDICINE

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	AC152270	OR

General Provider Information

NPI Number	:	1649523564
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O'NEILL ORIENTAL MEDICINE

Provider Business Mailing Address
First Line	:	PO BOX 15248
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97293-5248
Country	:	US
Telephone Number	:	503-329-1013
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 SW YAMHILL ST
Second Line	:	SUITE 200
City	:	PORTLAND
State	:	OR
Zip	:	97204-3019
Country	:	US
Telephone Number	:	503-313-5984
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DANIEL O'NEILL
Credential	:	LAC
Telephone Number	:	503-313-5984

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	10/16/2012

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Directions to “O'NEILL ORIENTAL MEDICINE ” Practice Location

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