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1861864076
MYRA THERIAULT
PORTLAND, OR
NPI
1861864076
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171100000X Acupuncturist
(Licence: OR AC174883)
Enumeration Date
2015-10-27
Last Update Date
2020-12-07
Business Address
MYRA THERIAULT LAc
4424 NE GLISAN ST
PORTLAND, OR 97213-2331
Phone number: 503-477-5167
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Mailing Address
MYRA THERIAULT LAc
4424 NE GLISAN ST
PORTLAND, OR 97213-2331
Phone number: 971-258-0902
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