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Organization
CALDERA ACUPUNCTURE LLC
Active
Organization
CALDERA ACUPUNCTURE LLC
Active
Other names
Caldera Acupuncture & Microneedling
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA CLARK L.AC. (OWNER OPERATOR)
(541) 961-7947
Entity
Organization
Contact information
Practice address
1045 NW BOND ST STE 202, BEND, OR 97703-2064
(541) 961-7947
Mailing address
19926 PORCUPINE DR, BEND, OR 97702-2090
(541) 961-7947
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205587
STATE LICENSE
OR
01
—
99088
STATE LICENSE
MT
Enumeration date
10/04/2022
Last updated
10/04/2022
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