MEDICARE: ACUPUNCTURE CASCADIA

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	AC171863	OR

General Provider Information

NPI Number	:	1841721495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE CASCADIA

Provider Business Mailing Address
First Line	:	1744 NE TAURUS CT
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6472
Country	:	US
Telephone Number	:	541-797-9962
Fax Number	:	541-610-1557

Provider Business Practice Location Address
First Line	:	31 NW GREELEY AVE
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97703-2911
Country	:	US
Telephone Number	:	541-797-3412
Fax Number	:	541-610-1557

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	DAVID GAINES
Credential	:	LAC
Telephone Number	:	541-797-9953

Provider Enumeration Date	:	03/24/2017
Last Update Date	:	03/24/2017

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Directions to “ACUPUNCTURE CASCADIA ” Practice Location

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