MEDICARE: CASEY ARON ACUPUNCTURE LLC

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

General Provider Information

NPI Number	:	1942906110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CASEY ARON ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	4203 SE HAWTHORNE BLVD STE A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97215-3160
Country	:	US
Telephone Number	:	503-758-7385
Fax Number	:

Provider Business Practice Location Address
First Line	:	4203 SE HAWTHORNE BLVD STE A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97215-3160
Country	:	US
Telephone Number	:	503-758-7385
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CASEY ARON
Credential	:	L.AC.
Telephone Number	:	503-758-7385

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	01/31/2023

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