MEDICARE: DR. REBECCA DAWN GROEBNER DAC, 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
1	171100000X	Acupuncturist	AC156285	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1063817450	OTHER	OR	GROUP NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821498908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA DAWN GROEBNER DAC, LAC

Provider Business Mailing Address
First Line	:	6427 NE 8TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97211-3607
Country	:	US
Telephone Number	:	503-575-5499
Fax Number	:	971-229-8922

Provider Business Practice Location Address
First Line	:	1235 SE DIVISION ST STE 106A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97202-1042
Country	:	US
Telephone Number	:	503-575-5499
Fax Number	:

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	10/30/2023

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