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NPI Code Detail

MEDICARE: DAVID C EISEN BS, MSW, OMD, LAC

MEDICARE: DAVID C EISEN BS, MSW, OMD, LAC
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
1171100000XAcupuncturistAC00106OR

Other Identifiers

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

General Provider Information

NPI Number : 1790827061
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID C EISEN BS, MSW, OMD, LAC
Provider Business Mailing Address
First Line : 2901 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-1831
Country : US
Telephone Number : 503-238-5203
Fax Number : 503-238-5202
Provider Business Practice Location Address
First Line : 2901 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-1831
Country : US
Telephone Number : 503-238-5203
Fax Number : 503-238-5202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/09/2007

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