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NPI Code Detail

MEDICARE: SEEDS OF HEALTH, PC

MEDICARE: SEEDS OF HEALTH, PC
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
1171100000XAcupuncturistAC01133OR

General Provider Information

NPI Number : 1922364694
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEEDS OF HEALTH, PC
Provider Business Mailing Address
First Line : 5525 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1258
Country : US
Telephone Number : 503-333-3722
Fax Number : 503-233-4449
Provider Business Practice Location Address
First Line : 5525 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-1258
Country : US
Telephone Number : 503-333-3722
Fax Number : 503-233-4449
Authorized Official
Title or Position : ACUPUNCTURIST
Name : SUSAN MARIE WILMOTH
Credential : L.AC.
Telephone Number : 503-333-3722
Provider Enumeration Date : 04/07/2012
Last Update Date : 04/07/2012

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