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Organization
ACTIVE ACUPUNCTURE CHIROPRACTIC AND MASSAGE LLC
Active
Organization
ACTIVE ACUPUNCTURE CHIROPRACTIC AND MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORTNEY ROUSE (CREDENTIALING/BILLING SPECIALIST)
(503) 860-8913
Entity
Organization
Contact information
Practice address
2440 SE 89TH AVE STE 3, PORTLAND, OR 97216-2053
(503) 771-5555
(503) 771-5556
Mailing address
2440 SE 89TH AVE STE 3, PORTLAND, OR 97216-2053
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
171100000X
Acupuncturist
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
04/13/2018
Last updated
04/13/2018
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