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1205226107
KELLY COREY SHAW
PORTLAND, OR
NPI
1205226107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171100000X Acupuncturist
(Licence: OR AC169285)
Enumeration Date
2015-01-29
Last Update Date
2015-01-29
Business Address
-- KELLY COREY SHAW LAc
6018 SE STARK ST
PORTLAND, OR 97215-1990
Phone number: 503-808-9145
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Mailing Address
-- KELLY COREY SHAW LAc
3280 SE MADISON ST
PORTLAND, OR 97214-4249
Phone number: 541-232-4016
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