| NPI | 1184764987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE GAULKE BLACKWOOD Owner 503-665-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: OR AC000567) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2017-04-18 |